The precordial catch syndrome is frequently mentioned as part of a long differential diagnosis of chest pain in children. It is an extremely common complaint but remains underrecognized. This review describes the distinctive features of the syndrome and points out that this is not a diagnosis of exclusion. Emphasis is placed on the need for taking a careful history to elicit the diagnostic features of the syndrome and performing a thorough physical examination. Diagnostic testing is usually unnecessary. Familiarity with the features of precordial catch syndrome should be helpful to primary care providers caring for children.