Pediatric and adolescent sports participation has increased with a concomitant increase in injuries. Sports have transitioned from recreational to deliberate, structured activities wherein success is determined by achievement of 'elite' status. This has led to specialization in a single sport with intensive, repetitive activity at younger ages causing physical and emotional consequences, particularly true for the growing athlete who is particularly susceptible to injury. Clinicians caring for this population must understand the epidemiology of youth sports specialization, the unique physiology/structure of this age group, and the potential physical and emotional consequences.