Objective of the study was to assess the prevalence of significant electrocardiogram anomalies and the prognostic value of the existing risk of sudden death in highly-skilled football players. Methods and structure of the study. We carried out a prospective cohort study to determine the incidence of the electrocardiogram patterns of high risk of sudden cardiac death based on the data obtained in the Russian highly-skilled athletes, members of the men's professional football teams (n=65, mean age - 23.3±6.4 years). During the survey, we determined the incidence of significant and insignificant heart rate and cardiac conductivity disorders according to the electrocardiogram data, as well as the dynamics of sports career during the 3-year follow-up period. Study results and conclusions. The electrocardiogram changes (when analyzed on ACCF 2009 recommendations) were found in 80% of the subjects (52 athletes), while 74% of them (59% of the total number, or 38 athletes) were regarded as non-pathological according t