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To determine the association between the apolipoprotein ε4 allele and concussion. We hypothesized that apolipoprotein ε4 carriers may be more likely to sustain a concussion.Prospective cohort study.University of Toronto varsity athletics.Included 318 of 822 collegiate student athletes who participated in University of Toronto varsity sports from September 2002 to April 2006.The presence of apolipoprotein ε4 was described dichotomously after genotyping blood samples collected from participants.Concussions were identified by sport-medicine professionals present on the sidelines using on-field assessment forms. All concussion diagnoses were verified by a sports medicine physician. Survival analysis was used to determine the association between apolipoprotein ε4 and first concussion.The unadjusted hazard ratio for concussion in the apolipoprotein ε4 carriers was 1.18 (95% CI: 0.52, 2.69) compared to noncarriers. Adjustment for sex, weight, height, and team type resulted in a hazard ratio of 1.06 (95% CI: 0.41, 2.72), indicating little effect from confounding factors.There is no important association between carrying the apolipoprotein ε4 allele and sustaining a concussion. At this time, we do not recommend preseason genetic testing for varsity athletes as a mechanism for targeting prevention strategies.