Background: Urinary incontinence (UI) can negatively affect a woman’s quality of life, participation in sport and athletic performance. The objectives of this study were to determine the prevalence of UI in competitive women powerlifters; identify possible risk factors and activities likely to provoke UI; and establish self-care practices. Methods: This international cross-sectional study was conducted using an online survey completed by 480 competitive women powerlifters aged between 20 and 71 years. The Incontinence Severity Index (ISI) was used to determine the frequency and severity of UI. Results: We found that 43.9% of women had experienced UI within the three months prior to this study. The deadlift was the most likely, and the bench-press the least likely exercise to provoke UI. ISI scores were positively correlated with parity (=0.227, p<0.001), age (=0.179, p<0.001), competition total (=0.105, p=0.002), and body mass index score ( = 0.08, p = .089). There was no significant correlation between ISI and years strength training (=-0.052, p=0.147) or years powerlifting (=0.041, p=0.275). We found a small negative correlation between ISI score with having had a pelvic floor assessment, (-2=0.04), or confidence in the ability to correctly perform pelvic floor exercises, (-2=0.03).Conclusion: The prevalence of UI in this cohort was at the upper limit experienced by women in the general population. Women who had undergone a pelvic floor examination or were confident in correctly performing pelvic floor exercises experienced less severe UI.