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The placement of automated external defibrillators (AED) at public sporting events is a growing national trend. The purpose of the present study was to investigate the prevalence, past use, and cost of implementing AED at university sporting venues.Questionnaires were sent to the head athletic trainer at all Division I NCAA universities (N = 326) and responses collected between August and November 2003.Completed surveys were returned by 244 institutions (75% response rate). Ninety-one percent (221/244) had AED for an average of 3.3 yr (range 1–13) with a median of four AED per institution (range 1–30). There were 35 cases of AED use for sudden cardiac arrest with 77% (27/35) occurring in older nonstudents, 14% (5/35) in intercollegiate athletes, and 3% (1/35) in a student nonintercollegiate athlete (information unavailable in two cases). The immediate resuscitation rate was 54% (19/35). A shock was delivered in 21 cases with a resuscitation rate of 71% (15/21). None of the intercollegiate athletes were successfully resuscitated. The average cost per AED was $2460. In a 10-yr model (expected useful life of an AED), the cost per life immediately resuscitated was $52,400, and the estimated cost per life-year gained ranged $10,500 to $22,500.Most Division I universities have AED available at selected sporting venues. Although no benefit was demonstrated for intercollegiate athletes, AED were successfully used in older nonstudents with cardiac arrest with a favorable long-term cost analysis.