This case report describes the history of a 13-year-old soccer player, born with a congenital heart malformation complex without cyanosis (Fallot Tetralogy of Fallot-Pink). This congenital heart disease was surgically corrected at the age of 10 months by the classic repair in Tetralogy of Fallot - an outflow patch of pericardium was used to relieve subpulmonic obstruction, and the VSD was closed with a pericardial or Dacron patch. The cardiac surgery led to an excellent result. After the radical heart surgery, the child had normal development, showing a natural inclination to physical activity. Since birth, he was followed by our pediatric cardiology unit,, where he performed a regular clinical and instrumental follow-up, from which it is documented that he never showed any kind of cardiac complication. He always practiced in recreational sports activity, but at some point he asked to engage in competitive soccer. Indeed, the aspiring young footballer has come into our medical center to undergo pre-participation screening and showed a better cardiorespiratory fitness than many of his peers with indices of optimal recovery. During the cardiorespiratory exercise testing, the athlete has achieved a maximum heart rate of 195 bpm at the height of the effort to a VO2 max >50 ml/min/kg and a ventilatory anaerobic threshold corresponding to 82% of VO2 max (Figure 1). Resting ECG showed sinus rhythm, normal AV and intraventricular conduction (QRS <100 ms), with normal repolarization. ECG during exercise testing did not detect arrhythmias (Figure 2). Subsequent transthoracic bidimensional echocardiography (Figure 3) showed excellent repair of the VSD and normal size and normal morphology of the left ventricle, with preserved systolic and diastolic function. Mild right ventricular enlargement and mild tricuspid regurgitation were present; no abnormalities of the RV outflow tract were found other than a trivial pulmonary regurgitation. The aortic root was normal size, without aortic valve regurgitation. Cardiac MRI was also performed, showing a slight dilatation and mild hypertrophy of the right ventricle, with normal biventricular contractile function and normal size of the aortic root and the pulmonary arteries, and without significant alterations of diameter at the level of the pulmonary valve (trivial regurgitation <5%) (Figure 4). In light of this evidence, in agreement with the pediatric cardiologist referent, he has been qualified as a competitive player, overcoming the restrictions of Italian Protocol COCIS 2009.