Background Shoulder pain and injury is common in both the general population and among athletes. Overhead athletes, such as handball players, are at an even higher risk of shoulder injury. There is currently no consensus regarding how or if these injuries can be prevented.  Purpose The aim of this review was to examine whether preventive training programs reduce acute and/or overuse injuries in overhead athletes. Another aim was to examine if training programs increase the strength of the rotator cuff in overhead athletes.  Method Searches were made in PubMed, Cinahl, and Sport Discus in March and April 2021. Ten studies were included in the study. The PEDro-scale was used to assess methodological quality and GRADE was used to determine level of evidence.  Results The methodological quality was “moderate to high” for five of the studies. The remaining five studies were of lower quality. The level of evidence was “limited” for prevention and “inadequate” for rotator cuff strength.  Conclusion The evidence for prevention of shoulder injuries was “limited” and the evidence for rotator cuff strength was “inadequate”. A narrower focus on one sport might result in more robust evidence.  Keywords overhead athlete, prevention, shoulder, strength