Background: Among college students, an incongruous association between physical activity (PA) and binge drinking (BD) has been reported. Purpose: The purpose of this study was to qualitatively investigate the relationship between PA and BD among college students. Methods: A trained facilitator asked open-ended questions, based on the social-ecological model, during sex-specific focus groups to inquire about PA and BD. Participants were physically active students (18-24 years, non-varsity athletes), who reported at least one binge drinking episode in the past 30 days. Transcripts were analyzed by 3 researchers to determine emergent themes. Results: Several intrapersonal, interpersonal, institutional, and community factors were identified. The most frequently occurring theme among females (n = 25) was "calorie conscious." "Damage control: healthy/unhealthy" was the most frequent theme/subtheme among males (n = 33). Discussion: The findings suggest multiple social-ecological levels that influence the complex relationship between PA and BD in college students. Although additional research is warranted, results of this study suggest that community-level factors greatly influence several intrapersonal and interpersonal level factors described by participants. Translation to Health Education Practice: It is imperative that Health Education professionals consider all social-ecological levels of influence when developing interventions and policies to promote PA and reduce BD among college students.