Sports supplements use is reality in the 21st century and the global sports world is enmeshed daily in media coverage and debate. Traditionally much of the focus has been on male athletes but the tide is shifting toward the rapidly evolving culture of the female athlete. Little is known about the use rates, reasons, and effects of sports performance supplements among females. This article examines female athletes and sports supplements with emphasis on historical influence, realities for the female athlete, risks involved in performance enhancement, and future recommendations.