To assess the feasibility of the orthopedic part of a standardized precompetition medical assessment (PCMA) in teams from countries with variable medical background and to collect data on medical history and musculoskeletal findings of the players participating in the 2006 FIFA World Cup. Retrospective analysis of the PCMA forms. Five hundred fifty-three players (75.1%) participating in the 2006 FIFA World Cup. The team physicians of participating teams were instructed to perform a specific standardized PCMA in all players before the 2006 FIFA World Cup. The orthopedic section included medical history and orthopedic examination of the lower extremity. The completeness of the orthopedic section was in general very high, but the quality of recordings and examination technique differed among teams. About half of the players (51%) were reported to have sustained at least 1 severe football injury, with ligament/meniscus lesions of the knee and ligament injuries of the ankle being the most frequent diagnoses. Pathological findings on examination were rare. A standardized PCMA including comprehensive orthopedic examination is principally feasible in international elite football. The challenge is to ensure the quality of the physical examinations and to verify their predictive value.