Stress fractures are common athletic injuries of the foot and ankle, described in every bone except the lesser toes, and reviewed here. Early diagnosis usually allows for simpler treatment and quick recovery. Early clinical presentations can be subtle, so a high degree of suspicion and a systematic approach, coupled with an understanding of the diagnostic limitations present in early injury, is required. Such a rigorous approach ultimately pays dividends for these patients, who are usually keen to return quickly to athletic activity. “High-risk” fractures include the medial malleolus, the talus, the navicular bone, the base of the fifth metatarsal, and the hallux sesamoids. We support recommendations of early surgery in high-risk fractures.