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Purpose The sudden cardiac arrest (SCA) of a professional athlete is a tragic, highly publicised event with profound implications. Recent studies have demonstrated that quick and effective defibrillation has the potential to prevent sudden cardiac deaths. Of concern, a study across European football arenas revealed significant deficiencies in emergency preparations, with up to a third of arenas lacking on site automated external defibrillators (AEDs), medical action plans and cardiopulmonary resuscitation (CPR) training programmes. This study aimed to map the emergency response planning and prevention strategies across professional football clubs in England and identify potential differences between top level and lower division clubs. Methods Between June and October 2014, in collaboration with The Football Association (FA), we sent a questionnaire to the medical personnel of all 92 professional clubs across the English football league. The questionnaire covered four key areas: cardiac screening; emergency planning; provision and training of AEDs; and provision of emergency services for the players on match days. Results With a response rate of 65%, 60 clubs responded to our survey (Figure 1). All clubs participated in cardiac screening as per The FA guidelines. All clubs provided AEDs for their players not only on match days but also during training sessions. In contrast to the Premiership however, where all clubs provided AED training to designated staff, almost 30% of clubs in the lower divisions had available devices but no formal training for the staff. The majority of clubs across all divisions reported the existence of an emergency action plan for SCA but the presence of documentation was variable. Almost all clubs in the Premiership and 1 st division who had an action plan had it clearly documented, while only 78% of clubs in the Championship and 63% in 2 nd division with a plan provided formal documentation. Finally, all clubs in the Premiership and 1 st division but only 70% of clubs in Championship and 2 nd division provided an ambulance on match day. Conclusions/implications Our study indicates that the majority of clubs in England have satisfactory prevention strategies and emergency response planning. In comparison to the ARENA safety study, clubs across the English football league outperform their European counterparts as all ensured AED provision and 70% provided a documented emergency action plan. Improvements, however, are necessary to further enhance cardiovascular safety of all athletes and close the gap between the Premiership and lower divisions.