In brief:Although preparticipation examinations are required for all Special Olympics athletes, information in the medical literature is limited concerning the difficulty in screening this group and in clearing them for competition. The results of 176 preparticipation exams are included in this report. The most striking finding was deficient visual acuity in half the athletes tested. Ruling out atlantoaxial subluxation in the athletes with Down's syndrome presented a special problem. The author suggests that the most effective method for screening Special Olympics athletes is a single-station/single-examiner format performed during school hours. She suggests improvements in the design of the consent forms to make physicians and parents aware of the special needs of these athletes.