When children and adolescents present to the emergency department with sports-related injuries, it can be challenging to differentiate apophyseal injuries from other common injuries such as fractures or muscle or ligament injuries. Recognition of apophyseal injuries can help facilitate optimal healing, prevent future injury, and minimize unnecessary testing. This issue reviews the major anatomic areas of apophysitis, presents guidance for activity modification and return precautions, and indications for when it is appropriate to refer patients for specialty care.