Lumbar bone stress injuries are a frequent cause of low back pain in children and adolescent athletes. They are approximately two to three times more prevalent in symptomatic athletes than in the general population. The key challenge is the early identification of an active, potentially healable lesion. MRI is the imaging modality of choice. Advanced "CT-like" bone MRI sequences allow for the early detection of defects and healing assessment without ionizing radiation, thereby limiting the need for CT. Management remains mainly conservative and aims at bony healing. It relies on respecting pain, avoiding pain-eliciting movements, strengthening the core, and addressing contributing factors (mechanical load, technique, relative energy deficiency in sport). The benefit of systematically using lumbar orthosis remains uncertain.