CONCLUSIONS Knowledge regarding pitch count guidelines and risk factors, along with compliance to established pitch count recommendations, remains suboptimal in youth baseball coaches, without improvement compared with prior survey results. Despite improvement in limiting breaking pitches, youth baseball pitchers remain at high risk for overuse injuries. Future prospective, observational studies, providing youth coaches with further evidence based recommendations highlighting the importance of compliance with pitch counts and recognition of fatigue are crucial to minimize the risk for overuse throwing injuries. As such, continued efforts to actively educate players, parents, and coaches are vital to ensure the implementation of safe pitching practices.