Concussion is common in contact sports. There are two major management dilemmas. The first is to decide when an athlete is fit to resume competition. Factors useful for evaluating recovery such as psychometric testing ‐ a quantitative measure of recovery ‐ are discussed. Risks of premature return to competition are outlined. The second management dilemma arises when there is risk of cumulative, or permanent damage. The effect of repeated concussion is not well understood and prospective studies are urgently required.