BACKGROUND: Problematic gambling is common in college students, and in particular, athletes. METHODS: The frequency of problem and pathological gambling was determined among 636 college athletes at three Midwest universities using the South Oaks Gambling Screen (SOGS). The Gambling Attitude Scale (GAS) was used to assess college athletes' attitudes toward gambling in general and toward four modes of gambling (casinos, betting on horse races, lottery and the Internet). A profile of college athletes' gambling attitudes and behavior was developed through the data obtained from each of these instruments. RESULTS: Nearly 15% of respondents had a SOGS score >or=3, indicating problem or pathological gambling. Those at risk for a gambling problem gambled frequently, had family and/or friends with perceived gambling problems, were nonwhite, older, started gambling at a younger age, preferred games of skill, and held positive attitudes toward gambling in general and Internet gambling, in particular. CONCLUSIONS: Gambling problems are widespread among college athletes who constitute a vulnerable group. Specific interventions are needed to target this group.