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The impact of a sedentary lifestyle during childhood and adolescence on pathological processes has become a major public health threat. Regular participation in a variety of physical activities during the pediatric years could reduce chronic disease and improve the quality of life of active participants. Although resistance training (RT) was once considered inappropriate for youth, there is a compelling body of evidence which demonstrate the safety and efficacy of RT for children and adolescents. In addition to increasing muscular strength, RT can result in favorable changes in body composition, bone mineral density and motor skill performance provided that the training program is well-designed and supervised by qualified professionals. Preseason conditioning programs which include RT have also been found to reduce sports-related injuries in young athletes. The purpose of this review is to evaluate the risks and benefits associated with youth RT and discuss program design considerations for promoting RT in school- and community-based programs as an on-going lifestyle choice.