© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Objectives: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used by athletes to treat injuries but are also reportedly misused as performance or recovery aids. This study aimed to investigate NSAID use, knowledge, and behavior regarding use and misuse of NSAIDs in Irish student-athletes. Methods: One hundred and forty-nine (21.2 ± 3.5 years) student-athletes completed an anonymous questionnaire online. Descriptive statistics were used to summarize the data. Univariate and multivariate regression analyses were utilized to examine whether the associated factors could predict NSAID misuse. Results: Ninety-four per cent of respondents reported using NSAIDs in the past, 63.8% used NSAIDs previously before or after competition and/or practice, and 13.9% took more than the recommended dosage and this was higher (22.9%) for over-the-counter NSAIDs. More than half were unsure of NSAID side effects. Misuse of NSAIDs was more common in respondents who had more favorable attitudes to the benefits of NSAIDs (odds ratio [OR] = 4.83, 95% confidence interval [CI] = 1.18–19.61), high reported stress (OR = 1.73, 95% CI = 0.58–1.73), or greater behavioral intention to use NSAIDs (OR = 1.89, 95% CI = 0.90–4.53). High perceived athletic identity also significantly predicted behavioral intention (p = 0.01). Conclusion: Education strategies to improve student-athletes’ knowledge of appropriate use and side effects of NSAIDs are recommended, particularly for those with high levels of stress and athletic identity.