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To determine the understanding of sport-related concussion among youth sports coaches.Cross-sectional survey.The survey was administered at coaches' meetings, following practices, and via mail.156 active youth sports coaches, with 5.88 ± 3.16 years (range 1-22) of coaching experience.An original survey instrument developed to assess concussion knowledge. Internal validity of the instrument was established prior to the study (Cronbach's alpha = 0.83).Scores on the survey instrument reflecting symptom recognition and management knowledge.For the 16 items comprising the symptom recognition survey, the mean number of correct responses was 9.78 ± 2.07. Previous coaching education was predictive of better symptom recognition. On the true/false portion, between 49.4% and 61.5% of coaches correctly answered the 4 statements.This investigation revealed that, among youth sports coaches, coaching education was predictive of the ability to recognize signs and symptoms of sport-related concussion. However, several misconceptions about concussion still exist, highlighting that education regarding concussion is necessary. The presence of qualified health care personnel, such as an athletic trainer, at the youth organization level may enhance early recognition, treatment, and referral of concussions.