Despite recent findings of cognitive, emotional, physical, and behavioral symptomatology in retired professional athletes with a history of multiple concussions, there is little systematic research examining these symptoms in high school athletes with a history of concussion. To identify cognitive, emotional, and physical symptoms at baseline in nonconcussed high school athletes based on concussion history. A multicenter sample of 616 high school athletes who completed baseline evaluations were assigned to groups based on history of concussion (none, 1, 2, or more previous concussions). The Post-Concussion Symptom Scale was administered as part of a computerized neuropsychological test battery during athletes' preseason baseline evaluations. Cross-sectional analyses were used to examine symptoms reported at the time of baseline neuropsychological testing. High school athletes with a history of 2 or more concussions showed significantly higher ratings of concussion-related symptoms (cognitive, physical, sleep difficulties) than athletes with a history of one or no previous concussions. It appears that youth athletes who sustain multiple concussions experience a variety of subtle effects, which may be possible precursors of the future onset of concussion-related difficulties. Copyright © 2011 by the Congress of Neurological Surgeons