Concussion is the most common head injury occurring in sports participation. Concussions range from a brief period of neural dysfunction to a prolonged period of unconsciousness with retrograde amnesia. It is imperative that the pediatric emergency medicine specialist be familiar with the proper initial assessment of the child or adolescent athlete who has sustained a sports-related concussion, the latest grading scales of concussions, and the current recommendations for returning the athlete to competition. A systematic approach to the athlete who has suffered a concussion will minimize the risk of further injury or mortality.