Background Accurately measuring shoulder strength in overhead athletes is critical, as sufficient strength is essential for safe and sustained performance during repetitive athletic movements. Isokinetic dynamometry (ID) offers dynamic strength assessments that surpass the capabilities of static methods, such as manual muscle testing and handheld dynamometry. The dynamic assessment provided by ID may enhance upper extremity evaluation, aiding in the prediction of injury risk and the determination of return-to-sport criteria for overhead athletes. Purpose The purpose of this review was to examine the existing literature concerning the application of isokinetic shoulder strength testing in rehabilitation and clinical decision-making processes among youth athletes who perform repetitive overhead activities. Study Design Scoping review Methods A comprehensive literature search was conducted using PubMed and EBSCO Host databases, covering publications from 2000-2024. Search terms included “isokinetic dynamometry,” “shoulder,” and “youth athlete.” Inclusion criteria focused on youth athletes (<18 years) engaged in overhead sports, excluding those with neurological conditions or those designated as college or professional athletes. The PRISMA-ScR guidelines were followed. Results A total of 23 articles met the inclusion criteria. Volleyball and swimming were the most studied sports, with the most common testing position being the seated 90/90 position. Variations in testing speeds and outcome measures, such as peak torque and external rotation (ER) ratios, were identified. Conclusions Isokinetic dynamometry is a valuable tool for assessing shoulder strength in youth overhead athletes. It provides critical insights into muscle strength dynamics, aiding in injury prevention and rehabilitation. Further research is needed to optimize strength assessment protocols and enhance clinical decision-making for safe return-to-sport practices.