Valgus extension overload syndrome of the elbow is common among throwing athletes and commonly results from repetitive valgus torque and deceleration across the elbow occurring during the late acceleration and early follow-through phases of the throwing motion. Non-operative treatment consisting of rest, anti-inflammatory medicine, correction of improper throwing mechanics, and a rehabilitation program to strengthen and coordinate the muscles should be tried first. Failure of non-operative treatment is an indication for open or arthroscopic removal of osteophyte and posteromedial decompression. Literature is divided regarding amount of olecranon resection to be done in posteromedial decompression but still it goes more in favor of removing only osteophytes in VEO syndrome.