Injuries can counter the beneficial effects of sports participation at a young age if a child or adolescent is unable to continue to participate because of residual effects of injury. Independent of activity level, injuries represent a considerable problem for the athlete and can result in an increased potential for future disability and inactivity. Injuries are also referred to as one of the major reasons for athletes to drop out of sports. Systematic injury registrations at the youth and adolescent level have been performed in recreational sports to gain knowledge on injury risk, as well as on the most common and most severe sport specific injuries. However, information on injury risk of the young athlete competing in high level sports seems less available or unknown. This paper reviews the current knowledge on injury risk of the youth and adolescent elite athlete participating in sports presented in the Youth Olympic Games 2010. Apart from football, little is known on injury epidemiology among young elite athletes. Systematic injury surveillance of this highly competitive population is needed to monitor injuries, identify high risk sports, and ensure new knowledge on injury trends, which can form the basis for further research on injury risk factors, mechanisms, and in the final step, on injury prevention.