The shoulder and elbow represent two of the most commonly injured joints in the adolescent population. Specific injuries vary by sport and can involve various structures, depending on the mechanism of injury. Unlike the adult shoulder, the immature skeletal structure of the adolescent athlete can lead to several unique injuries. By understanding the special demands placed on the immature shoulder, the sports physician can more effectively treat the resultant injury. This article reviews the diagnosis and management of unique injuries to the shoulder and elbow in the adolescent athlete.