Women are very familiar with the experience of being evaluated by their physical attractiveness. This socialization intersects across all stages of a woman’s development beginning in early childhood. Too often, college women’s beliefs about their own attractiveness influence their self-worth. This chapter provides an overview of the “beauty pageant effect”, a phenomenon in which college women compete against one another based on their physical appearance. In addition, exploration of the beauty pageant effect suggests that social comparison theory, evolutionary psychology, and realistic comparison theory play a significant role in the interactions of college women. The chapter presents negative impacts of this type of competition and discusses a brief overview of clinical implications. Prevention work needs to target all women on campus and especially any at-risk populations, such as women with a history of mood disorder, socially isolated students, and those with a personal or family history of eating disorders.