Despite remarkable progress, athletes continue to underreport concussions, as noted in this simple and eloquent study by Torres et al.1 Should we be concerned? Absolutely. Concussion is not a singular event, but rather a pathophysiologic process that can threaten the physical and mental health of the involved athlete, with varying and uncertain long-term consequences. There are many potential reasons for underreporting that need to be addressed comprehensively by all governing bodies of sport in a consistent and enforceable manner, including the following: