This review aims to cover the anatomy, mechanics, injury mechanism, physical examination, imaging, diagnosis and treatment of medial elbow pain in overhead athletes. Due to the repetitive valgus stress overhead athletes place on their elbows, they are susceptible to common causes of medial elbow pain. These include ulnar collateral ligament tears, ulnar neuritis, medial epicondyle apophysitis or avulsion fractures, flexorpronator muscle strains or tendinitis, and valgus extension overload syndrome. With a more detailed knowledge of the injury mechanisms and up-to-date treatment options for these patients, physicians will be able to prevent and better treat medial elbow pain in overhead athletes. © 2014 Wolters Kluwer Health.