Throwing and racquet sports produce large stresses at the elbow joint consisting of tension on the medial or ulnar side, and compression on the lateral or radial side. Medial tension can lead to tears of the common flexor origin or medial collateral ligament, ulnar nerve subluxation, or pronator teres syndrome. Bony lesions include fragmentation and partial avulsion of the medial humeral epicondyle (little league elbow) or even complete avulsion of the epicondyle. The possible sequelae of excessive lateral compression include osteochondritis dissecans of the capitellum, osteochondral fractures of the capitellum and radius, and loose bodies. Early and accurate diagnosis is essential to initiate proper treatment.