CONTEXT: Poor sleep is common in collegiate student athletes and is associated with heterogenous self-reported complaints at baseline. However, exploration of the long-term implications of poor sleep at baseline has been less well studied. OBJECTIVE: To examine the implications of insufficient sleep at baseline, and factors such as symptom reporting and neurocognitive performance at baseline associated with insufficient sleep, for risk of sport-related concussion (SRC). DESIGN: Cross-sectional study. SETTING: Undergraduate institution. PATIENTS OR OTHER PARTICIPANTS: Participants were 614 student-athletes. Athletes were divided into two groups based on hours slept the night prior to baseline testing: sufficient sleepers (>7.07 hours) and insufficient (=5.78 hours). Athletes that went on to sustain an SRC during their athletic careers at our university were identified. MAIN OUTCOME MEASURES: Four symptom clusters (affective, physical, cognitive, and sleep) and headache were examined as self-report outcomes. Four neurocognitive outcome measures were explored: mean composite of memory, mean composite of attention/processing speed, memory intraindividual variability (IIV), and attention/processing speed IIV. RESULTS: Insufficient sleepers at baseline were nearly twice as likely (15.69%) to went on to sustain SRC compared to sufficient sleepers (8.79%). Insufficient sleepers at baseline, whether or not they went on to sustain an SRC, reported a higher number of baseline symptoms compared to sufficient sleepers. When compared to either insufficient sleepers at baseline who did not go on to get an SRC or to sufficient sleepers that did go on to sustain an SRC, the insufficient sleep group that went on to sustain an SRC performed worse at baseline on mean attention/processing speed. CONCLUSIONS: The combination of insufficient sleep and worse attention/processing speed performance at baseline may increase risk of sustaining an SRC in the future.