Sudden cardiac death (SCD) in an athlete is tragic and, in many cases, may be avoidable. Pre-participation cardiac screening is performed for children and adolescents in many countries worldwide to reduce the likelihood of such a tragedy. The goal of these programmes is to identify young athletes at risk for SCD so that they receive appropriate treatment and can make informed decisions around activities that may exacerbate underlying disease or precipitate life-threatening arrhythmias. While not all studies have shown identical results, the addition of ECG to screening programmes saves lives. The rate of SCD in young athletes in the Veneto region of Italy decreased by 89% following programme initiation while the rate of SCD in unscreened non-athletes was unchanged.