The association between body image and adolescent substance use is underexplored despite the established relationship between body image and risky behaviors. The current study utilized data from the Health Behavior in School-Aged Children 2001-2002 survey, a nationally representative survey of youths in the United States. Measures included perceived size/weight, perceived attractiveness, ever tried smoking, currently a smoker, currently a drinker, and binge drinking in the previous 30days. Size and attractiveness perceptions were related to substance use, although the association differed by gender. The significant findings and implications are discussed.