The preparticipation examination (PPE) is a widely practiced method of screening athletes for medical limitations before sports participation. Although the PPE is widely implemented, there is little consistency regarding content or method in providing this important service. This lack of uniformity undermines the overall effectiveness of the PPE. The history, efficiency, and nature of athletic screening in adolescents are discussed in this article, and specific suggestions are offered on how the examination might be improved in the future. As sports participation among teens continues to change--in number of participants and in athlete-demographics--and as the field of sports medicine expands equally rapidly, the adolescent PPE, the commonest interaction between adolescent patients and the medical system, should be updated.