In August 2010, the National Collegiate Athletic Association (NCAA) mandated that all of its incoming Division I student-athletes be tested for sickle cell trait. Student-athletes have the additional options to provide proof of a previous sickle cell test result or decline testing, by signing a waiver releasing their institution of liability. This article addresses the origins of the NCAA recommendations, and stresses the importance of proceeding with care. In doing so, it seeks to start a discussion in the genetic counseling community as to what, if any, should our role be?