Pediatric female athletes represent a growing demographic in youth sports. The physical and mental health benefits of sport participation are widely known. Pediatric female athletes face unique health challenges, and many are intricately influenced by biopsychosocial pressures. The most notable is low energy availability (LEA) and its progression to reduced energy deficiency in sport (RED-S) which can be both intentional and unintentional. RED-S has broad physiological impacts on reproductive, immune, skeletal, gastrointestinal, cardiac, and mental health. This condition and its sequelae can negatively affect performance, increase the risk of acute and overuse injuries, and predispose pediatric female athletes to long-term potentially irreversible health problems. The goal of this chapter is to highlight the current knowledge of common injuries affecting pediatric female athletes and evaluate cost-effectiveness of the current management strategies.