The purpose of this study was to empirically examine the prevalence patterns of sexual risk-taking behaviors (i.e., unprotected sex and having multiple sex partners) in relation to levels of gambling problems and heavy episodic drinking (HED) status among U.S. college athletes. Data from a representative national sample of 20,739 U.S. college athletes were derived from the first National Collegiate Athletic Association national survey of problem gambling and health-risk behaviors. Among college athletes who were sexually active during the past year, males reported significantly higher prevalence of unprotected sex (10.2%) and multiple sex partners (14.6%) than females (7.9% and 9.3%, respectively). Using the DSM-IV Gambling Screen classification, as the level of gambling severity increased, the prevalence of sexual risk-taking behaviors also increased among female athletes, but decreased among male athletes. As regards the effect of heavy drinking, while both male and female HED athletes reported elevated sexual risk-taking, the effect of HED was twice as large in females as in males. It is important to note that the definitions of sexual risk behaviors in this study took into account committed sexual relationship status; hence, the results of this study need to be interpreted with the refined sexual risk measures in mind. Further investigations are warranted to help us better understand and explicate the interrelationships of sexual risk-taking behaviors, gambling, and heavy drinking among these college athletes. Findings from this exploratory study suggest new directions for future research and practice and also highlight the importance of a more inclusive multi-component approach to address these co-occurring youth risk behaviors.