Background and Objectives Although the frequency of cardiovascular events, especially the end manifestation of myocardial infarction, has decreased in recent years, cardiovascular disease continues to be one of the most frequent illnesses. Also it is known that the cardiac system sustains more stress at high altitudes than it does at intermediate altitudes. This leads to the question if young alpinists should undergo cardiac evaluation before setting out for a trip to the Himalayas or the Andes Mountains. Material and Methods This study analysed 86 young male, active backcountry skiers (26 ± 8.9 years) in the Swiss Alps (Gotthard area) for cardiovascular risk factors (diabetes mellitus, obesity, smoking, lack of physical activity) and cardiovascular diseases (coronary heart disease, myocardial infarction, valvular heart disease, heart rhythm disorders and hypertension) with a view to recommendations regarding the value of prior cardiac evaluation. Results In the sample of backcountry skiers in the Gotthard area, only a small proportion of participants had risk factors. Especially smoking - the most important risk factor - was rare. The general amount of physical activity with an average of almost ten hours a week was high in the analysed sample. Nevertheless, seven young backcountry skiers suffered from hypertension, and there was one case of a valvular disease and one case of an arrhythmogenic disease. Conclusions Based on these results, with a prevalence of more than one percent, prior cardiac evaluation seems to be advisable for skiers with risk factors if altitudes change from intermediate levels (2000 to 3000 meters) to the High Alps, and generally when mountaineering is practiced in high altitude (Himalayas, Andes Mountains) due to the decrease in oxygen partial pressure.