MRI (magnetic resonance imaging) is becoming increasingly important in the diagnosis of injuries in children and adolescents. However, the therapeutic relevance of the additional information gained in this way is discussed controversially. In addition to detailing the possible uses of MRI in pediatric and adolescent injuries, results from retrospective studies are presented. These results include post-traumatic X-ray images and MRI images in a total of 45 cases, in each case taken by two radiologists and two trauma surgeons anonymously from each other, which were then evaluated in an independent and standardized fashion and assessed in terms of their therapeutic relevance. Looking at the data collectively, it becomes clear that MRI is more useful in evaluating injury course, e.g., prolonged healing, and identifying complications than it is in the acute diagnosis of fractures. It is often used in the planning of further therapeutic steps. In addition, there are special indications in which MRI plays a central role, such as excluding internal injuries of the knee joint, concomitant injuries following patella or shoulder luxation, staging of osteochondrosis dissecans, identifying post-traumatic circulation disorders and assisting in the differential diagnosis.