Implications of participation in highly competitive sports by children from 7 through 12 years of age are examined. Evidence supports the conclusion that highly competitive sports are often harmful to both physiological and psychological growth and development. However, through participation in sports and physical activity, children can develop desirable psychological traits, such as a competitive spirit, cooperation, persistence, achievement motivation, self-assertiveness, respect for others, and the ability to deal with success and failure. There is no doubt that competitive activities are a psycho-social phenomenon of considerable consequence in the development of young children. Additional evidence suggests that, for health-related reasons, children should be motivated to engage in strenuous physical activity. Concluding remarks focus on controversial issues related to when and how children should begin athletic competition, and evaluate several arguments supporting highly competitive sports for children. Recommendations from the 20th World Congress of Sports Medicine to safeguard the physical and psychological welfare of children are briefly mentioned. (RH)