The medical supervision of athletes is a primary lask of the sports medicine; a basic tool to accomplish this is the pre-participation physical examination (PPE). The purpose ol the PPE as conducted in ltaly in order to give specific sports etigibility (VIMeS, Visita di ldoneita Medico Sportiva) is not to disgualify unfit individuals from practicing sport, but rather to ensure that subjects predis- posed to or affected by a disease can practice sports safely. ln the present study we evaluated factors predisposing to disease and determined which diseas- es, while not necessarily inducing to non-eligibility for sports activities, may be revealed by the VlMeS. Variables included medical history, anthropometric and functional characteristics (height, weight, body mass index, heart rate, blood pressuie). A total of 32. 652 athletes (8O% males, 20% females) undenwent a physical examination and diagnostic procedures (EcG, spirometry, urine tests, etc.) according to the ltalian PPE {VlMeS}protocol at the 19 $port Medicine operative Units associated with the ltalian Federation of Sports Medicine (FMSI). The results showed that the VlMeS, as conducted according to the compulsory protocol (including examination by a sports medicine specialist, ECG, spirometry, etc.), was able to detect a not insignificant percentage of subjects unfit for sports (1-3%} and, more importantly, in high- lighting: A) the presence of many risk factors such as smoking (0.8 % of suhjects 11 - I5 years old and 27.4 % of thosÉ 26-30 years old) and alcohol consumption {1 1.7%); B) the presence of pos- itive family history for diseases {errdocrine-metabolic disorders [61.8 %], vascular disorders 16.7%], cardiac disorder (12.8%); C] a relevant proportion of disorders diagnosed at the VIMeS (20.8%). This subjects were subsequently referred to approrpiate therapy and /or monitoring programs. Taken together this study sows that the VIM eS is an effective folter for health care , epidemiology and prevention.