Pediatric upper extremity injuries are among the most common reasons for emergency department visits in children, with fractures comprising a substantial portion. Radiologic imaging plays a critical role in the accurate diagnosis, classification, and management of these injuries. This chapter provides a comprehensive overview of the imaging modalities and diagnostic strategies essential for evaluating fractures and other injuries affecting the pediatric upper extremity, including the shoulder, elbow, forearm, wrist, and hand. Emphasis is placed on the unique anatomical and developmental characteristics of the pediatric skeleton, including growth plates and secondary ossification centers, which can complicate image interpretation. Conventional radiography remains the primary imaging modality, but the roles of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) are discussed in specific clinical contexts where additional detail or soft tissue evaluation is required. The chapter also addresses common injury patterns, mechanisms of trauma, and age-specific considerations, while highlighting potential diagnostic pitfalls and signs of non-accidental trauma.