Many pediatricians desire to work with young athletes. However, most pediatricians have not been trained to treat common musculoskeletal injuries in athletes. The tendency is to refer the athlete to a specialist with expertise in the management of musculoskeletal trauma. However, pediatricians should be more involved in the diagnosis, treatment, and rehabilitation of injuries to their patients who are athletes. The most common musculoskeletal injury in athletes is the ankle sprain. This article is a review of the basic principles of diagnosis and management of ankle sprains.