Stress fractures of the femoral shaft in athletes occur most commonly in the proximal third of the femur. They can, however, also be found in the mid- or distal third. Conservative treatment is highly successful in healing these fractures without complications. Athletes can usually return to activity in 8 to 14 weeks. Recognition of the symptoms characteristic of these fractures (vague thigh pain, diffuse tenderness, no trauma) will assist early diagnosis. Early definitive diagnosis can be made by radionuclide scanning or later, by plain radiography, if symptoms have been present for a sufficient period. Diagnosis is not limited to novice runners since runners with significant mileage, or baseball or basketball players, can develop femoral shaft stress fractures.