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Objective To examine the effect of age, sex, and concussion history on preseason scores from the ImPACT computer-based neurocognitive test battery in elite 12–17-year-old ice hockey players. Design Cross-sectional. Setting Participants were recruited from the most elite divisions (AA, AAA) of youth ice hockey leagues in Calgary and Edmonton, Alberta, Canada. Participants 714 Bantam (ages 12–14) (47 female, 161 male) and Midget (ages 15–17) (67 female, 439 male) hockey players. Assessment of Risk Factors Players completed a preseason ImPACT test before the 2011–2012 season. Outcome Measures Outcomes were composite scores <25th percentile (based on sample distribution) for verbal memory, visual memory and impulse control, and scores >75th percentile for visual motor speed, reaction time, and total symptoms. Results Using multivariate Poisson regression, adjusted for cluster by team, those aged 16–17 years were less likely to score <25th percentile in verbal memory (IRR=0.85; 95% CI 0.78 to 0.98) or >75th percentile in reaction time (IRR=0.79; 95% CI 0.69 to 0.91), but were more likely to score >75th percentile in visual motor speed (IRR=1.27; 95% CI 1.17 to 1.37) and total symptoms (IRR=1.14; 95% CI 1.04 to 1.25). Males were less likely to score <25th percentile in verbal memory (IRR=0.85; 95% CI 0.78 to 0.92), but more likely to score >75th percentile in visual motor speed (IRR=1.20; 95% CI 1.05 to 1.38) and total symptoms (IRR=1.21; 95% CI 1.02 to 1.44). Previous concussion was not predictive of ImPACT scores in the poorest quartile on any subscale. Conclusions Age and sex influence preseason ImPACT scores, although concussion history does not appear to have an effect. Acknowledgements The Sport Injury Prevention Research Centre is one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee. We acknowledge the funding from the McCarthy Tetrault Award, Alberta Innovates Health Solutions, and the Alberta Children’s Hospital Research Institute for Child and Maternal Health. Competing interests Author B Brooks declares research grant support from CNS Vital Signs (neurocognitive test battery publisher) and PAR, Inc (test publisher).%U http://bjsm.bmj.com/content/bjsports/47/5/e1.9.full.pdf