The purpose of this article is to familiarize sports medicine physicians with evaluation, initial management, and treatment of athletes with closed liver trauma. Ten percent of abdominal injuries are caused during sports-related activities. The liver is the most commonly injured organ in blunt abdominal trauma. Physical examination findings may be subtle or absent in patients with underlying liver injury. A paradigm shift toward nonoperative management in hemodynamically stable patients has led to a decrease in mortality. Return-to-play guidelines do not exist for closed liver injuries. These decisions are usually made on a case-by-case basis using basic return to play principles.