Many orthopedic emergencies can occur during a sporting event when children and adolescents are involved. This article covers the basic principles involved in three common orthopedic problems that are seen in sports medicine. Cervical spine injuries are potentially devastating and all physicians involved in children’s athletic coverage should be comfortable with the initial evaluation and transport of suspected cervical spine trauma. Shoulder dislocations are common in adolescents. An understanding of the pathology and natural history of this injury is important for physicians who are on the sidelines of sporting events, especially contact sports such as football and hockey. Finally, knowledge of basic principles regarding the acute management of fractures, including open fractures, is important for pediatricians because fractures are common events in many types of sports and also frequently present to the pediatric office.