Many well seasoned emergency physicians often find it challenging to assess and treat pediatric patients regardless of the complaint. Because of anatomic and physiologic differences, pediatric patients experience orthopedic injuries that are both unique and specific to this subset of the population. Emergency physicians must be aware of these nuances to properly diagnose and treat these injuries. An understanding of fractures unique to growing bone, such as buckle/torus and greenstick types, will provoke clinicians to have a keener eye when reviewing pediatric radiographs. The Salter-Harris classification provides a proven, generally accepted stratification of injury to describe and properly disposition pediatric fractures. Emergency physicians must also recognize a distal radial fracture, because it is the most common pediatric fracture, and the many complications of the supracondylar fracture. Nursemaid's elbow and ankle injuries are further common presenting complaints that are discussed. Recognition of child abuse and the work-up of the child presenting with a limp are additional areas that the Emergency physician should feel comfortable evaluating.