Introduction <p>Sexual practices commonly described as “rough sex” (e.g., choking, slapping) have become prevalent among young adults in the U.S. and internationally. Little is known about adolescents’ engagement in such behaviors. Using U.S. population data, we examined the prevalence and demographic correlates of rough sex behaviors among U.S. adolescents ages 14- to 17- years old.</p> Method <p>Data are from a confidential online U.S. nationally representative survey conducted in December 2022 and January 2023.</p> Results <p>Of the 1010 adolescents surveyed, 180 had engaged in partnered sex and were then shown questions about ten rough sex experiences. Nearly one in three (30.1%) sexually experienced 14– to 17-year-olds had done one or more of the ten rough sex practices to a partner in the prior year and 36.6% ever in their lifetime. More than one-quarter (27.6%) of sexually experienced adolescents reported that someone had done one or more of the rough sex practices to them with permission or consent in the prior year and 37.1% in their lifetime. Also, 11.7% reported that someone had done one or more of the rough sex practices to them without permission or consent in the prior year and 17.3% in their lifetime.</p> Conclusions <p>Among adolescents who had ever engaged in partnered sexual activities, both consensual and non-consensual rough sex experiences were prevalent. Some of these sexual practices—such as sexual choking/strangulation and smothering—pose significant risks to young people’s health.</p> Policy Implications <p>Findings may inform sexuality education curricula, clinical guidance, and public health guidance and interventions.</p>