With the growing popularity of sports and an increase in the number of people participating, it is inevitable that sports violence will continue to increase across the United States. Violence in sports is a serious problem and too often, it is expected or accepted in the sport venue. It seems that with each passing decade, society continues to place sports competitions and athletes on a higher level than they have ever been placed and in many instances, we have become desensitized to confrontations and altercations in sports. The purpose of this study was to determine the percentage of secondary-level head coaches who had experienced confrontations and altercations during their head coaching tenure. More specifically, we sought to answer the following research questions. 1) What was the proportion of head coaches in football, girl's basketball, and boy's basketball who have had a confrontation/altercation with spectators/fans players and parents? 2) Did the confrontation/altercation turn physical? 3) Has there been sufficient preparation for coaches to deal with confrontations/altercations in their professions and where do they receive their knowledge about confrontations/altercations? 4) Is there a need for more information and knowledge offered for high school head coaches on confrontations/altercations with spectators/fans, parents and players? The Confrontation & Altercation Survey was sent to 1,031 head coaches in North and South Dakota. North Dakota had 133 head football coaches, 181 girl’s basketball head coaches, and 184 boy’s basketball head coaches while South Dakota had 159 head football coaches, 188 girl’s basketball head coaches, and 186 boy’s basketball head coaches. A total of 349 surveys were returned for a return rate of 34%. Approximately 92% of all subjects reported having a negative confrontation/altercation with a parent; approximately 50% reported having a negative confrontation/altercation with a spectator/fan; and approximately 75% reported having a negative confrontation/altercation with a player. Only 3% of all subjects reported having a confrontation/altercation with a parent that escalated into physical contact; 2% reported having a confrontation/altercation with spectators/fans that escalated into physical contact; and 7% reported having a confrontation/altercation with a player that escalated into physical contact. Approximately 78% of the subjects reported they were not prepared to deal with parents, 82% reported they were not prepared to deal with spectators/fans, and 65% reported they were not prepared to deal with players. Approximately 78% of subjects said they would attend a workshop or conference regarding confrontations/altercations.