Abstract Purpose This study explores indicators of post-concussive behavioral symptom management strategy adherence in collegiate athletes. Methods Behavioral Symptom Management Strategy Recommendations were provided to 34 collegiate athletes (23 males, 11 females, ages: 18-22) at post-injury. At follow-up, athletes rated strategy adherence in overall frequency (never, rarely, sometimes, often, almost always). Athletes were administered the Sport Concussion Assessment Tool-5th Edition (SCAT-5) at post-injury and follow-up. Participant data was grouped by adherence frequency: Low (never-rarely, N=7), Moderate (sometimes, N=5), and High (often-almost always, N=22). Increases in SCAT-5 Total Symptom Score (TSS) and Symptom Severity Score (SSS) were calculated by subtracting baseline scores from post-injury scores. Score change outliers and instances in which baseline scores were higher than post-injury scores were removed. Results An overall significant mean difference in TSS and SSS changes from baseline to post-injury among adherence frequencies was found, F(2,31)=4.45, p=.02, F(2,31)=4.40, p=.021. Post-hoc tests (Tukey) demonstrated that increases in TSS from baseline to post-injury were significantly higher in athletes with High (M=8.73, SD=5.28, p=.03) and Moderate (M=10.40, SD=5.22, p=.039) adherence frequency compared to those with Low (M=3.00, SD=2.94). Similar effects were demonstrated for increases in SSS for High (M=21.77, SD=18.04, p=.043) and Moderate (M=29.80, SD=19.31, p=.029) compared to Low (M=3.71, SD=3.59). A significant correlation was found between adherence frequency and number of previous concussions, r=.39, p=.025. Conclusions Results suggest that greater increases in SCAT-5 TSS and SSS from baseline to post-injury and number of previous concussions are associated with a higher frequency of adherence to post-concussive behavioral symptom strategy recommendations in collegiate athletes.