The addition of the electrocardiogram (ECG) to the pre-participation examination (PPE) of athletes has been a topic for debate. Defining the ECG difference among sports modalities is crucial to help initiate its implementation in the PPE. In addition, ECG early repolarization (ST and J-point elevation) was associated with reduced overall survival and an increased risk for arrhythmic death (Tikkanen et al., 2009). Thus, we endeavored to provide more insight on the influence of sports modalities on ST and J-point amplitude in amateur athletes. Methods Computerized 12-lead ECGs were obtained in 131 male athletes (mean age 24.2±3.5 years) and 48 matched sedentary male controls (mean age 24.5±2.7 years) with a normal cardiovascular physical examination and without family and personal history of heart disease. Athletes were engaged in 9 different sports and were grouped into 4 categories: long-distance running, football/basketball/handball, judo/karate/taekwondo/boxing and dragon boat. The analysis focused on ST segment and J-point voltages of ECG 12 leads. Results ANOVA analysis yielded significant ST segment and J-point amplitude differences among sports in V3, V4, V5 and V6 (p<0.05). Specifically, the highest ST segment and J-point amplitude were found in long-distance