Two cases of blunt chest trauma caused by a baseball are reported, including one death. At least one of these was in consequence of cardiac concussion or commotio cordis, an entity not described in teh pediatric literature. Concussion of the heart is a functional injury, in contrast to cardiac contusion or cardiac rupture, which pertains to structural injury. However, a cardiac concussion appears more likely to have immediate, dire consequences than the structural injury of cardiac contusion. Both of the cases presented occurred in the Little League baseball setting. Blunt chest trauma is reported to cause two to three deaths in youth baseball each year. There appears to be an increased pediatric susceptibility to this type of injury. Unfortunately, these cases are quite resistant to resuscitative therapy. Devices and techniques for primary and secondary prevention exist, but have yet to be systematically verified and implemented.