Pediatric elbow injuries represent diagnostic dilemmas to all health care personnel. In particular, nondisplaced lateral condyle fractures are often missed when the child first presents for evaluation, and if left untreated, can potentially produce disastrous results. Several illustrative cases are described in order to demonstrate the diagnostic symptoms and signs, as well as the long-term complications associated with the failure to diagnose and institute early treatment. Pertinent clinical findings and elbow anatomy are also reviewed.