Osteochondritis dissecans (OCD) of the capitellum is an uncommon disorderseen primarily in the adolescent overhead athlete. Unlike Panner disease,a self-limiting condition of the immature capitellum, OCD is multifactorialand likely results from microtrauma in the setting of cartilage mismatch andvascular susceptibility. The natural history of OCD is poorly understood,and degenerative joint disease may develop over time. Multiple modalitiesaid in diagnosis, including radiography, MRI, and magnetic resonance arthrography.Lesion size, location, and grade determine management, which should attemptto address subchondral bone loss and articular cartilage damage. Early, stablelesions are managed with rest. Surgery should be considered for unstable lesions.Most investigators advocate arthroscopic dbridement with marrow stimulation.Fragment fixation and bone grafting also have provided good short-term results,but concerns persist regarding the healing potential of advanced lesions.Osteochondral autograft transplantation appears to be promising and shouldbe reserved for larger, higher grade lesions. Clinical outcomes and returnto sport are variable. Longer-term follow-up studies are necessary to fullyassess surgical management, and patients must be counseled appropriately.