Based upon the current study, the review of the literature, and our experience, the preparticipation physical examination for Special Olympics is an opportunity for physicians of all specialties to assist and encourage a group of athletes with special physical and emotional characteristics not found in other athletes. The physician should review the medical condition of the athlete (including prescribed medications and their potential side effects), the physical demands of the proposed activity, and the presence of volunteers to assist the athlete when necessary. Full or limited participation should be recommended in most cases. "No participation" should only apply to unstable medical conditions or situations that would place the athlete at risk for injury despite activity modification and close supervision.