Mild traumatic brain injury in sports has become a significant public health concern which has not only received the general public’s attention through multiple news media stories involving athletic concussions, but has also resulted in local, state, and national legislative efforts to improve recognition and management. The purpose of this article is to review the current literature for return to play (RTP) guidelines. State, regional, national, and professional legislation on sport-related concussion RTP management issues will be reviewed. This article will be helpful in developing a generalized systematic approach to concussion management and highlight specific RTP guidelines. The article will also touch upon specific contraindications to RTP, the role of neuropsychological testing in RTP, and other considerations and complications that affect an athlete’s ability to return to competition. Finally, considerations for terminating an athlete’s competitive season or ending a career after sustaining a concussion resulting in prolonged and protracted symptomatology or repeated concussions will be reviewed. PubMed and Google were searched using the key terms mentioned below. In addition, the author’s library of concussion-related articles was reviewed for the relevant literature.