Transitional fractures are a rare injury to the distal tibia that occur only in adolescents because of the asymmetric closure of the physis. These fractures can occur in multiple planes and have varying number of fragments, depending on the amount of closure that has taken place in the distal tibial physis at the time of injury. A thorough evaluation of a suspected transitional fracture requires advanced imaging studies for diagnosis, prognosis, and treatment planning. Accuracy is paramount in treatment of these injuries to prevent long-term complications. This article is a review of the literature on transitional fractures, with a case presentation.