Sickle cell trait (SCT) in America football athletes has been a topic of recent media attention. The deaths of college football athletes Ereck Plancher, Aaron O’Neil, Dale Lloyd and others as well as the recent decision of Pittsburgh Steelers safety Ryan Clark to forego a play-off game at altitude in Denver have contributed to the characterisation in the lay press of SCT as a dangerous condition. In fact, deaths in National Collegiate Athletic Association (NCAA) football players and concern from NCAA member institutions for the health and safety of student athletes led to legislation mandating all Division I athletes be screened or know their SCT status since August of 2010. On 26th January 2012, the American Society for Haematology (ASH) denounced the NCAA position. The disparity between these two positions is striking and deserves comment.