This article reviews the status of concussion management in child and adolescent athletes. Children and adolescent athletes represent a distinct group from adult athletes, although past concussion guidelines have not specifically addressed these differences. It is the position of this article that younger athletes need to be considered as a separate group and that conservative management of concussion is often called for. Neurodevelopmental differences between adult and child athletes are highlighted and new developments in the management of concussion in youth sports are discussed.