Diving is a sport presenting unique environmental and physiological hazards to its participants. Despite this, scuba diving is an enjoyable and safe hobby, with an estimated rate of 250,000 new divers certified each year. The ears, nose, and paranasal sinuses are the source of the most common problems in divers. Proper otorhinolaryngic medical examination is vital in the certifying of diving candidates and in routine examinations of active scuba divers. Most authorities agree on major guidelines applicable in ENT examination, although some points are a matter of controversy. Based on the major sources on the subject and our own experience, we have listed disqualifying disorders and relative or temporary contraindications for sport scuba diving. Although there are no regulations specifying medical standards for sport divers in the United States, we have tried to provide guidelines for the general practitioner and ENT specialist engaging in an otolaryngic medical examination of a sport scuba diver.