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Several articles have been published recently on overhead throwing athletes. This review summarizes current thinking on injury mechanisms and biomechanics of the throwing motion. The concept of internal impingement is an overarching theme in recent literature on throwing injuries of the shoulder, and the pathomechanics of this problem are reviewed. Injury to the medial ulnar collateral ligament of the elbow also is common in throwers secondary to valgus overload. There may be a correlation between glenohumeral internal rotation deficits and injury to the medial ulnar collateral ligament. Most throwing injuries can be initially managed nonoperatively, using appropriate rehabilitation and retraining modalities.