American football holds immense cultural significance, from its impressive youth participation rates to the coverage of professional football. However, the reach of American football extends beyond cultural significance, as societal values and norms are frequently mimicked or even amplified in major sport settings. American football is a context that highlights the privileges of heterosexuality and cisgender people, effectively discouraging people from disclosing their lesbian, gay, bisexual, transgender, and queer (LGBTQ+) status. Because LGBTQ+ inclusion has received less attention in the American football context, and bias against LGBTQ+ people is common in sport, this paper aimed to explore LGBTQ+ inclusion in American football. Drawing on our related scholarship in this area, we present a multilevel framework, highlighting macrolevel (i.e., societal), mesolevel (i.e., organizational), and microlevel (i.e., individual) factors that shape LGBTQ+ inclusion in American football. The discussion includes strategies to implement LGBTQ+ inclusion in American football, as well as a call for further research.