Purpose: To examine the influence of neurocognitive perfor- mance and concussion history on balance with a cognitive distraction task (dual-task). Methods: A total of 165 Division I varsity student-athletes (84 males; age: 18.2 ± 0.8 years) completed a neurocognitive test (Immediate Post-Concussion Assessment and Cognitive Test) and no distraction (single-task) and cognitive distraction (dual-task) balance tasks under different sensory conditions using a Biodex Balance System (Biodex Medical Systems, Inc., Shirley, NY). Balance sway scores and kinematic measures were assessed across visual, surface, and cognitive load conditions. Visual, proprioceptive, and vestibular sensory ratios were also assessed. Results: Vision, surface, and cognitive load significantly affected sway scores and kinematic performance (P < .05). Neurocognitive performance and visual motor speed were significantly correlated with balance performance as measured by vestibular ratios in dual-task conditions (P < .05). A stepwise multiple regression found that number of concussions and visual motor speed predict the sway index vestibular sensory ratios in the distraction dual-task condition (P < .05). Conclusions: The use of vision and surface and adding a cognitive load all have an influence on balance performance. Visual motor speed and number of concussions may be predictive of vestibular decrements in balance performance during a distraction dual cognitive task. Thus, balance testing that includes a dual-task and foam surface may help identify deficits at baseline and during recovery.