There have been increased opportunities and sports participation by athletes with disabilities during the past decades. Research on pediatric athletes with disabilities remains limited. Appropriate classification of athletes on the basis of their functional abilities is key to fair participation. Preparticipation evaluation of these athletes is based on similar principles as for able-bodied athletes. The prevalence, nature, evaluation, differential diagnosis, and treatment principles for injuries are similar for athletes with disability and for those without. There are few disability-specific medical and orthopedic issues to be considered in working with these athletes. Sport participation recommendations are based on the specific disability and demands of the sport. The vast majority of athletes with disabilities can participate safely in a number of sports if appropriately matched; such participation should be encouraged and facilitated at all levels because of well-recognized psychological and medical benefits. Significant progress has been made in increasing sports participation opportunities for persons with disabilities; this is especially true for adults and, to a lesser extent, for children and adolescents. Many barriers remain, however: inadequate facilities, exclusion of children with disabilities, medical professional overprotection, lack of trained personnel and volunteers to work with children with disabilities, lack of public knowledge about disabilities, and lack of financial support for sport and physical education in schools [9,12].