This study demonstrated that ECM-BMAC grafting is a viable treatment strategy for pediatric patients with unstable, contained capitellar OCD lesions. We observed favorable PROs ≥1 year postoperatively with an ~90% RTS rate at an average of 5.8 months, supporting the results of this technique that has demonstrated success in other anatomic regions and adult populations. These findings suggest ECM-BMAC grafting to be a viable treatment option for contained capitellar OCD lesions. Although these early results are promising, longer-term research studies are paramount in determining the outcomes of patients with capitellar OCD lesions treated with ECM-BMAC grafting.