This article summarizes available population-based data related to the risk of sudden cardiac death during exercise and the factors that influence the risk among apparently healthy adults in the community. Recent evidence puts into perspective the cardiac risks and benefits of exercise. The data suggest that although the occurrence of sudden cardiac death during acute bouts of exercise is not a chance occurrence, the transient increase in risk is outweighed by the cardiac benefits of habitual exercise. The implications of these findings for both clinical practice and public health are reviewed.