X-ray studies were made of both elbows of 162 boys in the 9 to 14 year age group, divided into three categories: Pitchers, non-pitchers, and a control group who had never played organized baseball. Changes involving the medial epicondylar epiphysis and opposing articular surfaces of the capitulum and head of radius in the throwing arm appeared to be in direct proportion to the amount and type of throwing. The most striking changes were in the arms of pitchers. Some degree of accelerated growth, separation and fragmentation of the medial epicondylar epiphyses was noted in the throwing arm of all 80 pitchers in the study. Five cases of traumatic osteochondritis of the capitulum and head of radius, and one case of juvenile osteochondritis of the head of the radius were also found among the pitchers. Better medical supervision and stress on prevention are needed, especially in the Southern California area where climatic conditions favor prolonged seasons and throwing practice the year around.