The focus of this paper is the children with identified Cardiovascular Abnormality, and its goal is to develop prudent consensus recommendations regarding the eligibility of such children for competition in a sport. To accomplish this objective. I have attempted to ascertain by way of consensus which Cardiovascular Abnormalities and with what degree of severity would place the competitive athlete at increased risk for sudden death or disease progression, thereby justifying a medical recommendation against participation in certain sports. Both parents and physicians are involved with efforts to maximize recreational and competitive sports participation in Children with congenital heart disease while at the same time minimizing any potential risks. In this regard, it is fortunate that significant morbidity or mortality precipitated by exercise in patients with congenital heart disease is rare. Indeed, there are relatively few congenital heart lesions that have been associated with sudden death during sports participation. The most common are hypertrophic cardiomyopathy, congenital coronary artery anomalities, Marfan’s syndrome, and myocarditis with less common causes including Valvular aortic stenosis, and complex defects tetrology of fallot, complete transposition and single ventricle, and those associated with Pulmonary Vascular Disease. The recommendations for the permitted level of activity are offered only as guidelines.