Spontaneous and traumatic pneunothoraces are rare conditions found occasion
ally in athletes. Although generally not life-threatening, these conditions
can be fatal if not appropriately diagnosed and managed. Expedient diagnos
is depends on a thorough understanding of possible presenting signs and sym
ptoms such as chest pain, dyspnea, and diminished breath sounds. A chest ra
diograph maybe required for definitive diagnosis. Management depends on the
size, stability, and type of pneumothorax and may include serial monitorin
g, tube thoracostomy, pleurodesis, or apical resection. Return-to-play guid
elines after pneumothorax have not been previously published. We present re
comendations based on a review of published case reports, our clinical expe
rience, and communication with North American sports medicine providers.