Although exposure to blood-borne pathogens and potential allergic reaction to pigments are well documented health risks related to tattooing, the number of Americans choosing to engage in this health risk behavior is increasing. Estimates indicate that 1 in 6 college students (16.6%) possess at least one tattoo. Results from a recent study of approximately 800 tattooed college students enrolled at 18 universities across the United States indicate 73% of those with at least one tattoo received their first tattoo while in college. Because tattooing behavior is similar to, and often associated with, other health-risk behaviors such as alcohol consumption, drug use, and tobacco use, attempts to reduce these behaviors through a "just say NO" type campaign will likely prove to unsuccessful. However, attempts to reduce health risks related to these behaviors while encouraging thoughtful decision making may prove successful. The purpose of this research project was to assess college students' behaviors, intentions and perceptions related to tattooing. As part of a 2 year research project, a preliminary sample of 162 students enrolled in a freshman-level university course at an urban university was surveyed. The sample was reflective of university enrollment. Approximately 50% of the subjects were between the ages of 21 and 25. The majority of subjects were female (61.1%) and Caucasian (80.2%). The 26-item instrument employed was based upon the Transtheoretical Model of Behavior Change. Results indicate that 44 of the 162 subjects (27.2%) have at least one tattoo. Of those without a tattoo (n=118), 15 (12.7%) plan to get a tattoo in the next 6 months. Eighty-two percent of those with a tattoo received their first tattoo after the age of 18. The most common reason for getting a tattoo was "self-expression" (75%). The most common reasons for not getting a tattoo were "OK for others but not for me" (54.9%), "concern about health risks" (48%), and "pain" (39.2%). Seventy-nine percent of those surveyed overestimated the social norm related to tattooing with 31.5% indicating they believe that more than 50% of college-aged people have a tattoo. These results indicate not only that a large number of college students have and plan to get a tattoo, but that they perceive possession of a tattoo to be "normal". Factors influencing decision-making related to tattooing will be discussed in greater detail. Information gleaned from this study will lend to the development of health risk-reduction programming related to tattooing.