Little league elbow, seen in throwers aged 8 to 14 years, is an overuse injury to the fusing medial epicondyle apophysis from repetitive throwing in the absence of acute injury. Athletes typically present with medial elbow pain during throwing and sometimes at rest. At times, ulnar nerve irritation causes paresthesias in the ulnar distribution. Comparison radiographs may be necessary to appreciate widening or sclerosis of the medial epicondyle.