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Recent surveys indicate that the use of androgenic-anabolic steroids (anabolic steroids) is prevalent among adolescent athletes, particularly those in high school. The cost of clinical drug testing makes it impractical to use random testing to identify users of these ergogenic aids. The athletic trainer is often in a position to identify anabolic steroid users if he/she knows the clinical signs and symptoms. In this article, we briefly discuss the history of anabolic steroid use, how they work, their potentially dangerous side effects, evidence of increased use by adolescent athletes, and a list of clinical signs and symptoms. Finally, we suggest strategies that may help athletic trainers counsel athletes about anabolic steroid use.