Knee injuries in children and adolescents often involve the growth plate (physis), as well as the adjacent bony areas of the femur, tibia, or patella. Young patients who have injured knees require careful clinical and radiographic assessment to determine the extent of their injuries, with specific management to minimize the potential for growth arrest and resultant deformity. This article discusses distal femoral physeal, proximal tibial physeal, tibial eminence, patellar sleeve, and tibial tubercle fractures in skeletally immature patients.