Sports and physical activity in children are healthy and have numerous positive mental and physical health benefits. Recently, there has been a shift away from deliberate play and focusing on specializing in a single sport from a young age. Participating in rigorous training and competition schedules 8 months out of the year for prepubescent athletes has garnered attention from the medical community. It is assumed that this type of early specialization has the potential to cause negative effects, especially in terms of overuse injuries, nutritional deficiencies, poor sleep hygiene, and mental health concerns. While there appears to be a consensus among the sports medicine community regarding the potential for deleterious effects and anecdotal correlation between early sport specialization and a variety of injury risks, there is a current gap in the literature and a lack of useful data for evidence-based guidelines and recommendations. Youth sports is a multi-billion dollar industry and the pediatric sports medicine healthcare community needs to address the trend towards early sport specialization to protect the health of our children now and as they grow into adulthood.