In a prospective study among 667 recruits, the incidence of asymptomatic femoral stress fractures was compared using a new expanded stress fracture clinical examination (SFCA) versus an older stress fracture examination. There was a statistically significant difference (p = 0.0001) between the percentage of femoral stress fractures that were asymptomatic in the group evaluated by SFCA (26%) and those evaluated by the older stress fracture examination (80%). By using the SFCA, many of the femoral stress fractures previously classified as asymptomatic are in fact recognized as symptomatic.