Purpose: The true incidence of radial nerve birth injury remains unknown due to presentation overlap with obstetric brachial plexus injury. These injuries may present with discrete clinical signs including palpable nodules or ecchymosis over the posterolateral arm and typically have favorable prognoses without surgical intervention. This study aimed to characterize patient presentations, recovery trajectories, and global management experiences for radial nerve birth injuries at a tertiary paediatric brachial plexus service. Methods: A retrospective single centre review of all patients with radial nerve birth injury between 2016 and 2024. Patients were identified from clinical coding as well as from clinic attendance. A literature review was conducted not limited by time or language. Results: Thirteen patients were identified with radial nerve birth injury with 14 affected limbs. Six (43%) affected limbs were right sided; eight (61.5%) were female. Median age at diagnosis by the specialist centre was 60 days (range 1-185 days). Four (29%) limbs had ecchymosis on the arm and five (36%) had a palpable nodule. Median time to recovery, as determined by a health care professional at the tertiary centre, was 162 days (90-824 days). All patients were offered physiotherapy; no child required surgery. A further 98 cases were identified from the global literature and only one patient required surgery, making an incomplete recovery. Conclusion: It is important to consider isolated radial nerve injuries when referring and assessing a child for obstetric brachial plexus injuries, particularly in the presence of ecchymosis or a palpable nodule on the posterolateral arm. Radial nerve birth injury has a good recovery trajectory by 6 months of age with physiotherapy alone. It is useful to ensure that all patients are assessed using a common evaluative tool, such as the Active Movement Scale, to ensure comparison between global work.