The present review aims to provide a synopsis of the current literature on little league shoulder, including etiology, diagnosis, prevention, and treatment.As management involving little league shoulder has not drastically changed over recent years, most current research evaluating youth throwing athletes with shoulder pain relates to biomechanics and prevention. Current literature on biomechanics indicates that the maximum shoulder external rotation and ball release phases of throwing provide the highest rotational torque and distraction forces, respectively, with the maximum external rotation phase being most likely related to the development of little league shoulder. In addition, targets for prevention have also been identified in youth throwing athletes, including current or prior history of shoulder pain, variability in mechanics, glenohumeral internal rotation deficit, and accordance with throwing guidelines, especially in at-risk baseball pitchers.Little league shoulder is most commonly seen in youth throwing athletes between 11 and 16 years of age. Clinical evaluation and radiographic imaging typically confirms the diagnosis. Management is most effectively performed through prevention. With the onset of little league shoulder, nonoperative treatment is typically successful, with a 3-month period of rest followed by a progressive throwing program with subsequent return to play.