This study explored male and female college students' knowledge of and attitudes toward emergency contraception pills (ECPs).A survey of 692 undergraduate college students (338 male and 358 female) was conducted at a mid-size university in northwest Pennsylvania during the Spring 2008 semester.Eighty-three percent of the participants had experienced sexual intercourse, and 52% of them had feared a pregnancy at least once. Only 17% of the participants indicated prior use of ECP. Seventy-four percent of the students had heard of emergency contraception (EC); however, less than one-third knew the prescription status, common side effects or mechanisms of ECP. Only 16% of the participants knew that ECP was available at their college health center. Fifty percent of the students reported that they would feel comfortable using ECP, and 58% felt that ECP should be available without a prescription.College students' knowledge level about EC is poor. There is a clear need for ECP as a pregnancy prevention method among college students and for better education about it.