OBJECTIVE: To identify the prevalence of tendinopathy and describe the predictive factors of condition and chronic tendon pain in high-performance athletes. DESIGN: Cross-sectional observational study. SETTING: Sports training centers and competitions. PARTICIPANTS: Federated high-performance athletes. MAIN OUTCOME MEASURES: Tendinopathy and chronic tendon pain. RESULTS: Out of all recruited athletes, 30.6% had a confirmed diagnosis of tendinopathy. Tendinopathy prevalence was 36.5% in athletes with extremely high training exposure index (TEI), compared to 21.9% in those with low TEI (p = 0.03). There was a significant difference in the prevalence of tendinopathy sites between the sport modalities, TEI classification and sex. Almost 60% had chronic tendon pain, 48% had required a break from training, and 19% reported that the condition affected two or more tendons. Being older than 25 years (OR = 3.5
95%CI = 2.0-6.2), female sex (OR:0.5
95%CI:0.3-0.9) and receiving nutritional guidance (OR:1.7
95%CI:1.3-2.4) were identified as factors associated with tendinopathy. Protection from chronic tendon pain was associated with male sex (OR:0.6
95%CI:0.3-0.9) and nutritional guidance (OR:0.5
95%CI:0.3-0.9). CONCLUSION: This study reports the difference of tendinopathy prevalence according to sexes stratified by TEI classification. Chronic tendon pain was associated with female sex, lack of nutritional guidance, and more than three episodes of condition manifestation.