Pediatric extremity trauma represents one of the most frequent yet often under-recognized emergencies encountered in primary care and emergency settings. Given the unique anatomical, physiological, and developmental characteristics of children—such as pliable bones, open growth plates, and a distinct response to shock—assessment and management must be adapted accordingly. This chapter provides a comprehensive, primary care provider (PCP) centered guide to the evaluation and stabilization of musculoskeletal injuries in children, with a focus on practical, actionable strategies grounded in evidence-based care. Through a case-based narrative, the chapter outlines the importance of early recognition and response to extremity injuries, incorporating the ABCDE approach for primary survey and structured secondary assessment. Common injury mechanisms such as road traffic accidents, falls, and child abuse are reviewed, alongside red-flag signs of life-threatening or limb-threatening conditions like open fractures, neurovascular compromise, and compartment syndrome. Emphasis is placed on the essential role of PCPs in the initial stabilization—airway maintenance, fluid resuscitation, bleeding control, and analgesia—while also guiding referral decisions, splinting techniques, wound care, and discharge planning. Practical algorithms, checklists, and visual tools are provided to assist PCPs in making rapid, informed decisions, even in resource-limited or high-pressure settings. Beyond clinical management, the chapter addresses effective communication with families, detection of non-accidental injuries, and integration into multidisciplinary trauma teams. It underscores the value of cultural sensitivity, psychological support, and clear documentation in enhancing care quality and outcomes. By empowering PCPs with clear frameworks and essential pearls of pediatric extremity trauma care, this chapter aims to reduce morbidity, ensure timely referrals, and improve long-term recovery for injured children across diverse care settings.