This habilitation thesis addresses the relevance and necessity of preventive sports medicine diagnostics, with a particular focus on the importance of preventive diagnostics in sports medicine, especially for young top athletes. While the existing literature on preventive diagnostics for adults and athletes in general tends to focus on the general population, this thesis aims to provide insights into the specific needs of elite athletes in their respective sports or on adolescent elite athletes. In particular, this group of elite athletes has received less scientific attention with regard to preventive sports medicine diagnostics in the past. In order to ensure effective preventive care of these athletes, however, it is important to be able to recognize the physical condition of the entire organism in connection with high physical demands. This study focuses on less recognized sports, such as ski mountaineering, and aims to expand knowledge and understanding of the broad complex of preventive sports medicine examinations. It also addresses previously marginalized areas, such as oral health, gingival inflammatory reactions, and their effects on athletic performance. A comparative study of performance diagnostic and echocardiographic data in 31 world-class winter athletes (biathletes, cross-country skiers, and ski mountaineers) revealed significant echocardiographic differences between the participating disciplines. With excellent performance data for all athletes, there were significant differences between the cross-country skiers and biathletes on the one hand and the ski mountaineers on the other. In order to conduct validated stress tests on the ergometer with children and young athletes, there was not yet sufficient knowledge available on the stress-induced blood pressure behavior of these trained children and adolescents. In a study of the maximum exercise blood pressure, age-adjusted percentiles were created in order to establish a standard basis for assessing physicians. Similarly, it has only been speculated whether an increased parasympathetic influence, as is assumed in children participating in elite sports, leads to similar ECG changes as in obese children, in whom an increased parasympathetic tone is also assumed to be a possible cause. Although no relevant pathological findings were identified in children of normal weight, obese children, or children involved in competitive sports, children involved in sports exhibited a significantly shorter QTc time than obese children. Additionally, two further studies investigated dental health and individual oral health behavior, as well as the interaction of oral health and systemic inflammation in relation to athletic performance in competitive athletes. These studies demonstrated that this aspect is crucial for the prevention and optimization of performance development. The results indicated that an increased inflammation in the oral cavity had no significant influence on individual performance. Furthermore, systemic inflammatory processes were not associated with low oral inflammation in the athletes studied.