<p>Technological advances and regulatory changes have substantially expanded access to sports wagering in the United States, raising concerns about gambling behaviors among collegiate athletes. Since 2004, the National Collegiate Athletic Association (NCAA) has conducted a large-scale survey every four years to monitor gambling behaviors among student-athletes. The present study examined trends in gambling among NCAA student-athletes over a twenty-year period. Data were drawn from five waves of the NCAA National Study on Collegiate Wagering conducted in 2004, 2008, 2012, 2016, and 2024. Across these cohorts, more than 100,000 student-athletes completed anonymous surveys assessing gambling participation, sports wagering behaviors, attitudes toward gambling, and problem gambling severity. Gambling activities were measured using the Gambling Activities Questionnaire, and gambling severity was assessed using DSM-IV-TR criteria for pathological gambling. Descriptive analyses were used to examine trends across survey years. Overall gambling participation declined over time, with increasing proportions of non-gamblers and decreasing rates of social gambling among both men and women. Rates of at-risk and probable pathological gambling remained low and relatively stable. Male student-athletes consistently reported higher gambling participation and sports wagering than females. Notable shifts included increases in fantasy sports betting, parlay bets, live in-game betting, and prop bets, often conducted through mobile platforms. Although overall gambling participation has declined, evolving forms of sports wagering and greater accessibility through online platforms present new challenges. Continued prevention, education, and responsible gambling policies are needed to protect student-athletes and preserve the integrity of college sports.</p>