**Abstract**

Sudden death is associated with sports, while rare is a disastrous event. Sudden death in athletes often has a cardiac etiology. Hypertrophic cardiomyopathy and congenital coronary artery anomalies are the two most frequent causes. The existing recommendations are to perform a pre-spots participation screening consisting of full personal and family history and detailed physical examination. If abnormal findings in history or physical examination are found, additional investigations should be performed to define the nature of abnormalities. Employing an electrocardiogram, echocardiogram, or magnetic resonance imaging as a routine screening technique is not recommended in the US. The rationale of pre-participation screening is to allow as many athletes as feasible to take part in the sports.

**Keywords:** sudden cardiac death, athlete, pre-participation screening, electrocardiogram, echocardiogram, hypertrophic cardiomyopathy, aberrant coronary artery, Marfan's syndrome
