OBJECTIVE: To present an overview of medical screening of athletes in Australia DATA SOURCES: Data was obtained from Australian sports physicians involved in elite national and professional programs. DATA SYNTHESIS/METHODS: The status in Australia of medical screening and in particular the Pre-participation Examination (PPE) was reviewed. RESULTS: The PPE as practised in North America is not performed in Australia. However medical screening of elite national level and professional athletes is widely practised. A variety of screening methods is used. The medical screening protocol recently developed on behalf of the Australasian College of Sports Physicians (ACSP) is presented. CONCLUSIONS: Medical screening of high performance athletes takes place regularly in Australia. Valuable information may be obtained from this process. The extent of the screening is limited by financial and time constraints. The proposed protocol is a basis for a comprehensive medical screening, but can be adapted depending on the individual and the sport played.