In brief:Exercise-related sudden death is a clinical syndrome that is well known both to the general public and to the medical community. Autopsy studies of victims have identified multiple structural cardiovascular diseases underlying sudden death in young athletes (aged 30 years and younger). These diseases include myocardial, coronary arterial, aortic, valvular, and cardiac conduction system disorders. In athletes over 30 years of age, the underlying cause is almost invariably severe coronary artery disease. The author discusses these diseases, along with apparent mechanisms of sudden death, clinical points, risks of exercise stress testing, and cardiac rehabilitation, as a basis for attempts to prevent these tragic events.