Stress fractures are common among female athletes, especially runners. Although both intrinsic and extrinsic factors can contribute to stress injury etiology, the female athlete triad--negative energy balance leading to menstrual irregularity, and reduced bone mineral mass--is a significant contributor to the incidence of stress fractures in the female athlete. When combined with impact weight-bearing activity, this triad puts these women at increased risk for stress fractures. Treatment must focus on reversing identified risk factors, in addition to relative rest, and maintenance of fitness. Most stress fractures heal without complication. High-risk stress fractures should be evaluated and treated by a practitioner with expertise in the care of these injuries.