Commotio cordis due to blunt trauma to the precordium is a rare cause of death in young athletes, occurring less frequently than all of the other athletics-related deaths. Commotio cordis is a term used to describe cases of blunt thoracic impact causing fatality without structural damage of the heart and internal organs. Death is attributed to ventricular fibrillation, which is often resistant to resuscitative therapy. In this article we discussed this catastrophic event, its historical development, epidemiology and clinical presentation, mechanisms for sudden death in commotio cordis, limitations of evidence using animal models, autopsy findings, resuscitation and preventive measures.