Objective Previous studies reported that concussions occur more frequently in female athletes than in male athletes; however, there have been no studies conducted on Japanese athletes. Therefore, we aimed to investigate concussion history among Japanese athletes and examine its prevalence by sex.

Design A retrospective survey.

Setting Subjects consisted of elite Japanese athletes in 65 sports.

Participants A total of 1,277 Japanese Olympic game candidates (666 males and 611 females) were included.

Interventions (or Assessment of Risk Factors) An online health survey was conducted at the time of medical screening, which asked history of concussions. This study was conducted from January 2021 until January 2022.

Outcome Measures Chi-square test was used to determine if prevalence of concussion history differed by sex and sports.

Main Results More female athletes reported concussion history than male athletes with significant difference (χ2[1] = 3.894, p = 0.048, φ = 0.048). In addition, the proportion of concussion history was higher in the winter Olympic candidates than the summer Olympic candidates (χ2[1] = 51.789, p < 0.01, φ = 0.201).

Conclusions Concussion was more prevalent among Japanese elite female athletes than male athletes, which is similar to previous studies conducted in other countries. Furthermore, the trend was stronger in winter sports, indicating that there is an urgent need to develop countermeasures to mitigate concussion risk among elite female and winter sport athletes.