Background: This study examined the relationships between watching wrestling on television (TV) and engaging in health risk behaviors among an older multi-state sample of adolescents. Methods: In 2001, a random sample of 2,307 youth ages 16 to 20 years from 138 communities in 17 US states completed telephone surveys as part of the national evaluation of the Enforcing Underage Drinking Laws Program. The survey measured multiple health risk behaviors, including substance use, involvement in date fighting, other violent behaviors, and sexual risk behaviors. The frequency of watching wrestling on TV during the two week period before the survey was measured with a scale of 0 to 14 or more times. Multivariate analyses were conducted with logistic regression using a generalized estimating equation (GEE) model with an exchangeable correlation structure that controlled for within-group clustering. Data are presented as adjusted odds ratios (OR) and 95% confidence intervals. Results: Males (22.4%) reported watching wrestling more than females (13.6%). After adjusting for ethnicity, sex, median family income, age, region of the country, other fighting behaviors, and family composition, the frequency of watching wrestling was associated with having tried to hurt someone with a weapon (OR = 1.67, CI = 1.05-2.66), engaging in sexual intercourse without using birth control (1.42, 1.01-1.98), being a current cigarette smoker (1.31, 1.02-1.69), and not drinking (0.64, 0.48-0.85). When the frequency of watching wrestling was treated as an independent variable, after adjusting for covariates, each additional time wrestling was watched on TV was associated with an increased risk of being in a date fight (1.16, 1.02-1.30), threatening to hurt someone with a weapon (114, 1.02-1.28), hurting someone with a weapon (1.19, 105-1.34), and engaging in sexual intercourse without using birth control (1.13, 1.03-1.23). For example, youth who had watched wrestling six times during the past two weeks were 144% more likely to have engaged in a date fight than adolescents who had not watched wrestling. Conclusions: The more frequently these adolescents reported watching wrestling on TV, the more likely they were to engage in violent and other health risk behaviors.