Adolescent participation in sports is at an all-time high. Younger patients also are competing with a greater intensity level, frequently playing organized sports throughout the year. Players are putting greater demands on their shoulders, making them more prone to injuries. Because these players are in the process of skeletal development, certain considerations are needed for this patient population. There is controversy regarding the appropriate treatment of these adolescent athletes including debate on injury prevention; nonsurgical treatment versus surgical treatment; overuse injuries; and return to play after shoulder fractures, dislocations, and instability. It is valuable to review evidence in the current literature regarding recommendations for the treatment of shoulder injuries in adolescent athletes.