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Baseball is a very popular and safe sport for children and adolescents. Understanding bone maturation and risk factors for overuse will guide the practitioner to manage these athletes properly. Overuse injury risk can be minimized by limiting pitch counts, ensuring adequate recovery, developing proper mechanics, and allowing for early evaluation and intervention. Rest, albeit difficult for the athlete, is the mainstay of treatment for many of the maladies affecting this age group of throwers. Individualized approaches to treatment for this population are advised. Structural damage that may lead to surgery is rare but may need consideration if there is no response to conservative measures. Several resources are available to educate players, coaches, and parents regarding safe play.