Paralympic participants represent a special subset of athletes. Although sudden cardiac death in this group is a rare event, it should be underlined that, in particular, Paralympians with movement restrictions have a higher prevalence of coronary heart disease. Numerous reports have focused on comparing athletes with spinal cord injury (SCI) and the ones with non-spinal cord injury-NSCI. The first group is more prone to develop arrhythmias, arterial hypertension, hyperlipidaemia including atrial fibrillation and atrial flutter, and this group potentially may have a higher risk of cardiovascular mortality. In ECGs of the disabled athletes with SCI, we more often find changes typically established as consequences of exercise training, such as T-wave inversions. The potential differences in the cardiovascular status of disabled athletes may depend not only on the class of impairment, but also on the discipline of sport and environmental conditions, which makes the analysis relatively complex. The paper analyses up-to-date articles discussing the cardiovascular problems in disabled athletes, pointing to scarce data in several fields of interest. Previous studies on the frequency of abnormalities of the cardiovascular system in Paralympic athletes highlighted the need to intensify preventive cardiology care for this group of athletes, and some activities could be proposed for sportsmen and sportswomen in this group, including more frequent screening ECG, application of 24 h ECG Holter monitoring, echocardiography and cardiological care. Due to the relatively few data available and existing discrepancies in this area, further research is necessary.