PurposePrevious research suggests that many active females are not engaging in sports bra use, despite the positive health benefits. The aim of this study was to establish and compare sports bra use, preferences and bra fit issues for exercising females in some of the largest and most diverse global underwear markets (the US, the UK and China).Design/methodology/approachA survey covering activity levels, sports bra use and preferences, bra issues and demographics was administered via Qualtrics and completed by 3,147 physically active females (aged ≥ 18 years) from the US (n = 1,060), UK (n = 1,050) and China (n = 1,037).FindingsIn general, participants were 25–29 years, 121 to 140 pounds, 34B bra size and pre-menopausal. “I cannot find the right sports bra” was the most frequent breast barrier to exercise (25.4%). Three-quarters of women wore a sports bra during exercise, with significantly higher use in China (83.9%), compared to the UK (67.2%). A third of all participants reported sports bra shoulder straps “digging into the skin”. Sports bra preferences were: compression sports bras with a racer back, wide straps and thick straps in the US and the UK; thin straps in China and adjustable straps and underband, no wire and maximum breast coverage in the US and the UK, including nipple concealment and with padded/moulded cups.Originality/valueInformation provided on differences in sports bra use, preferences and bra issues across three major global markets could be utilised by brands and manufacturers to optimise bra marketing and fit education initiatives and inform future sports bra design and distribution strategies.