Adolescent pregnancy rates are higher in the United States than in other developed countries. Clear policies and procedures are necessary for managing pregnancy in the secondary school setting. This study aimed to determine if athletic trainers had a policy for, and their confidence in, managing pregnant athletes in the secondary school setting. Sixteen percent of the participants have previously managed adolescent pregnancy, yet only 4% had a policy. Athletic trainers with pregnancy policies and procedures or previous experience managing pregnancy reported greater confidence in managing pregnancy in adolescent athletes. Participants were only “slightly confident” in managing pregnant adolescent athletes.