This study examined the incidence, type of electrocardiogram abnormalities, and associated risk factors in healthy paediatric athletes. A single-centre retrospective cohort study was conducted on a local male youth competitive soccer programme, ages 11-18. The primary outcome was the incidence of electrocardiogram abnormalities. The secondary outcomes were recurrence and the type of electrocardiogram abnormalities. Covariables were age, race, family history, and current medications. Statistical analysis program was used for analysis. There was a total of 368 electrocardiograms reviewed from 2021-2024, of which 68 (18.5%) had at least one abnormality. 182 unique athletes were screened. A higher proportion of multi-racial and African American athletes had electrocardiogram abnormalities (-value 0.02). In our sample of healthy paediatric athletes, electrocardiogram abnormality incidence was similar to that noted in other studies. There were no significant cardiac findings noted after further evaluation on any of the athletes with abnormal electrocardiogram findings. Our data support that universal electrocardiogram screening of healthy paediatric athletes is not beneficial.