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Context: Therapeutic ultrasound is a widely used modality, however, little is known about the knowledge level of athletic trainers regarding therapeutic ultrasound. Objective: To examine athletic trainers' perceived and actual knowledge of therapeutic ultrasound concepts. Design: Cross-sectional. Setting: Web-based. Patients or Other Participants: Randomly selected collegiate athletic trainers (35.55 ± 8.86 years). Intervention: The questionnaire included: Likert scale questions regarding perceived knowledge of the educational competencies related to therapeutic ultrasound; actual knowledge questions regarding theory/textbook validated knowledge; frequency of use questions; and demographics. Main Outcome Measures: Correlations. Results: Athletic trainers in collegiate settings reported fairly high confidence in their knowledge of the application-related therapeutic ultrasound competencies. Athletic trainers reported less confidence in their knowledge of the theory-related competencies. The actual knowledge mean score was 15.50 ± 2.88 out of 22 possible points. The 13 questions that were answered correctly by less than 75% of the participants related to insufficient parameters, safety concerns, and theory/book knowledge. Weak to moderate positive relationships were found between actual knowledge scores and perceived knowledge scores, age group, and number of therapeutic modalities courses taken. Weak to moderate positive relationships were found between perceived knowledge scores and both age group and number of courses taken. Conclusions: Athletic trainers were more confident with application-based questions than they were with theory-based questions. Though overall confidence in their knowledge of therapeutic ultrasound concepts was high, actual knowledge scores were relatively poor. Actual knowledge scores were higher in older age groups and in those who had taken more therapeutic modalities courses. The use of inadequate intensities and inadequate treatment durations, as outlined by Draper in 1998, were still seen. While a self-assessment tool may be helpful for some, this study suggests that more research is needed regarding whether athletic trainers have an accurate understanding of their need for continuing education in this area. [ABSTRACT FROM AUTHOR]