Running is a popular sport for children in the United States. However, review of available literature on health effects and safety recommendations for youth running has not been previously conducted. Unique factors for injury include periods of growth during puberty and potential for growth plate injury. Youth runners may benefit from activities that incorporate high-impact loading and multidirectional movement for optimal bone maturation, exercises to strengthen tendons and muscles, and strategies aimed at improving running biomechanics to reduce risk of injury. In addition, addressing lifestyle factors, including nutrition and sleep is essential for a runner's general health. Similar to other sports, sports specialization should not be encouraged in youth runners. Reducing running-related injury in growing children and assessing readiness for running should be based on a combination of physical, emotional, psychological, social, and cognitive factors. Youth runners require individualized training and competition to safely participate in the sport.