In brief: Children are at high risk of growth plate injury, contrary to previous research data. Of 134 consecutive growth plate injuries seen at the University of Arizona Hospital in Tucson over a six-year period, 22% occurred in team sports and 20% in activities such as using playground equipment, horseback riding, roller and ice skating, skateboarding, and bicycling. The authors review clinically useful anatomical and biomechanical aspects of the growth plate and its injuries, reflecting their own research as well as other studies. They also discuss prevention and diagnosis of this common source of childhood injury.