Stress fractures (SF) are overuse injuries in athletes, often presenting with insidious, activity-related pain. Early diagnosis is essential to avoid complications. Initial X-rays are often normal, potentially delaying treatment. Point-of-care US is increasingly used to diagnose SF but the method is operator-dependent. MRI is the diagnostic gold standard. Clinical suspicion should be high in at-risk individuals, including those with low energy availability. Timely imaging and individual management improve outcomes, as argued in this review.