Background: There is still much that we do not know about differences in sports injuries between young male and female athletes and the factors that may increase the risk for injuries in this regard. Purpose: To describe and compare differences between males and females in pediatric sports-related injuries. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective chart review was performed using a 5% random sampling (N = 2133) of medical records of children aged 5 to 17 years seen over 10 years in a sports medicine clinic at a large academic pediatric hospital. Information was collected and analyzed on age, sex, height, weight, injury type (overuse vs acute/traumatic), location of injury, and sports involvement. Results: Overall, female athletes had a higher percentage of overuse injuries (62.5%) compared with traumatic injuries (37.5%); the opposite was seen in male athletes (41.9% vs 58.2%, respectively; P < .001). Looking at specific areas of injury, female athletes sustained more injuries to the lower extremity (65.8%) and spine (11.3%) as compared with male athletes (53.7% and 8.2%, respectively). Male patients had a greater percentage of injuries to the upper extremity (29.8%) as compared with female patients (15.1%). The type of hip/pelvis injuries differed greatly by sex, with females sustaining more overuse (90.9%) and soft tissue injuries (75.3%) versus males, who suffered injuries that tended to be traumatic (58.3%) and bony (55.6%) in nature. Males were more likely than females to participate in team and contact/collision sports. The percentage of females with patellofemoral knee pain was approximately 3 times greater than that of males (14.3% vs 4.0%, respectively; P < .001). Males were twice as likely as females to be diagnosed with osteochondritis dissecans (8.6% vs 4.3%, respectively; P < .001) and fractures (19.5% vs 8.2%, respectively; P < .001). The percentage of males and females who sustained an anterior cruciate ligament injury was almost equal (10.0% and 8.9%, respectively; P = .369). Conclusion: Sports injuries in young males and females differed by injury type, diagnosis, and body area. These results may be related to the referral patterns unique to the division of the hospital, including a high number of female dancers. Further investigation is required to better understand the injury risk in pediatric male and female athletes.