In a routine checkup the family history of an elite female mogul skier was found to contain an unusually high number of thrombotic incidents. This prompted us to do diagnostic thrombophilia studies, which revealed a resistance to activated protein C, a heterozygous factor V Leiden disorder. This is the first documented case of APC resistance in an elite female athlete. Since high performance sports are known to carry an increased risk of thrombogenesis, measures to avoid thrombosis or a thromboembolic event must be initiated in case of known APC resistance. Suitable measures are early anticoagulation during periods of immobilization, a single dose of low molecular weight heparin, leg muscle exercises for long distance flights, and avoidance of hemoconcentration with a sufficient oral fluid intake.