The preparticipation evaluation (PPE) is the first step toward meeting the responsibility of maintaining the health and safety of the athlete. The ideal timing for the PPE is 6 weeks prior to the competitive season to allow adequate time for treatment and rehabilitation of problems. It is suggested that a complete screening evaluation be performed prior to entrance into a new level of school with annual limited reevaluations thereafter. The annual reevaluation should focus on the medical history with the physical examination emphasizing the cardiovascular system and interim injuries and medical problems. Currently, there are no data to support routine screening laboratory, radiographic, or cardiovascular testing in the asymptomatic athlete with an unremarkable history and normal examination. Two different methods for performing the PPE can be used (station-type mass screening and office setting), with each having its own distinct advantages and disadvantages. The most important and difficult decision for the physician screening young athletes is determining clearance for activity. Guidelines based on the demands of the sport and specific medical problems have been established; however, the physician's clinical judgement should be used in interpreting these recommendations for each individual athlete. The PPE is an excellent opportunity for the physician to positively influence the health care and safety of a local sports program. Through genuine interest, thorough evaluation, and knowledgeable counseling, the athlete will develop confidence in the evaluating physician. This confidence can translate into a good relationship and hopefully this interaction will encourage the athlete to trust the physician's judgement and seek early evaluation and treatment for problems that arise.