CONTEXT: Immediate athletic trainer (AT) availability for acute injuries is essential as worse long-term outcomes are associated with delays in receiving medical care. Several factors have been found to influence AT availability between secondary schools, but few studies have evaluated how medical coverage varies between athlete groups. OBJECTIVE: The purpose of this project was to identify factors that impact the time to AT evaluation following acute sport-related injury in a secondary school setting. DESIGN: Cross-sectional study. SETTING: Retrospective analysis of deidentified patient records via the Athletic Training Practice-Based Research Network. PATIENTS OR OTHER PARTICIPANTS: High school athletes diagnosed with an acute sport-related injury during in-season play from 2010 to 2023. MAIN OUTCOME MEASURE(S): Time to AT evaluation was measured as the number of days between injury onset, reported by the patient, and AT evaluation. RESULTS: This report consists of 17 354 patient cases representing 20 different sports. Overall, 46.9% (n = 8138) of patients who sustained an injury during in-season play were evaluated by an AT the same day (range, 0-14 days). Significant group differences were reported for sex (P <
.002), setting (P <
.002), and sport level (P <
.01), with female athletes and in-game injuries associated with longer times to AT evaluation. Freshmen were evaluated sooner than junior varsity (P <
.01) and varsity (P <
.002) athletes. No difference was observed between junior varsity and varsity athletes (P = .34). CONCLUSIONS: Almost half of patients received medical care within 24 hours following an acute injury during in-season play, highlighting how qualified health care is accessible for many student-athletes through ATs in the secondary school setting. Differences in time to AT evaluation may be attributable to sex discrepancies in immediate medical coverage between sports and injury reporting patterns among athletes.