When properly organized and conducted, the preseason physical examination process for scholastic athletes can identify existing medical and musculoskeletal problems as well as provide for age-specific anticipatory guidance. This examination may also present an ideal opportunity to screen for adolescent hyperlipidemia. Seven-hundred seventy-seven (777) students, aged 11 to 15 years, from seven junior high schools received fingerstick cholesterol screening during a complete preseason physical examination. Elevated values were verified by repeat examination. Values were compared with previously published national norms for this age group. All students received information on cholesterol, and the parents and pediatrician or family physician of those with confirmed positive tests (higher than 4.8 mmol/L [185 mg/dL]) were notified. One hundred fourteen (114), or approximately 15%, of the subjects were found to have elevated cholesterol levels. Of the 74 who returned for a second test, 38 (51%) were confirmed as having elevated cholesterol levels. Feedback from parents, principals, and coaches regarding the value of the screening and the associated education was overwhelmingly positive. In our experience, the precompetition examination provides an opportunity to screen for elevated cholesterol levels and to educate young people about hyperlipidemia.