Background: The purpose of this study is to make an overview of the assumed pathogenic mechanisms underlying Shaken baby syndrome and the differential diagnoses that have to be considered when diagnosing an infant with presumed Shaken baby syndrome (SBS). Method: A literature study based on a selection of articles gathered by these searches in PubMed: “Shaken baby syndrome” and “shaken baby syndrome and differential diagnoses”. Results: Shaken baby syndrome has been defined in different ways, but there is an established triad consisting of subdural hematoma, encephalopathy and retinal bleedings. Different mechanisms of injury and various conditions are proposed as differential diagnoses like falls, benign extern hydrocephalus, resuscitation, obstetric factors, metabolic and genetic conditions, coagulopathies and choking. Conclusion: When making a diagnosis of Shaken baby syndrome several other conditions and mechanisms have to be excluded. Further research is also needed to get a better understanding of SBS and to establish as safe and scientific criteria as possible.