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An estimated 3 million youth participate in youth baseball. The purpose of this review is to highlight musculoskeletal development and specific throwing-related injuries in youth baseball players, as well as the current knowledge of pitching biomechanics, which are closely intertwined with the both arm development and injuries. Methods: A systematic literature review was conducted to highlight musculoskeletal development, throwing-related injuries and pitching mechanics. Results: Youth athletes are actively going through skeletal maturation which includes the formation of new bone at the epiphyseal plate, increasing muscle mass and/or strength, and morphological changes in tendons and ligaments. These processes setup youth pitchers to sustain throwing injuries at their shoulder and elbow in ways that differ from their adult counterparts. Faulty pitching biomechanics may also cause throwing injuries. Deviation from proper mechanics at any point can cause injuries in the shoulder and elbow. Conclusion: Many musculoskeletal changes occur during the development of a youth baseball player. Some of these changes are beneficial for improving throwing performance, but also predispose the athlete to injury. Improper biomechanics may be related to the throwing-related injuries that are seen in youth baseball players.