This article reviews current issues in the following areas of pediatric sports-related concussion: incidence of concussion, potential long-term effects, return to play, and the emergence of legislation regarding concussion education and management programs. Incidence of concussion is presented in context of emergency room visits, as well as under-reporting of concussions. The literature on history of concussion is reviewed, for high school, collegiate, and professional athletes, with respect to potential long-term effects of cerebral concussion. Specific discussions of effects include: decreased cognition and increased symptom reporting following multiple concussions, and recent diagnoses of chronic traumatic encephalopathy in non-professional and youth athletes. Recent legislative and advocacy efforts are reviewed, including mandated programs in specific states.