Cosmetic surgical procedures have previously been associated with some risks to psychological and physical health. Yet such procedures are on the rise, highlighting the need for a better understanding of the factors which might underlie the decision to undergo cosmetic surgery. In a sample of 297 young adults (192 women), we examined the relationship between intrasexual competition (IC), social comparison, and individuals' attitudes, perceived risks, and desired spending on cosmetic surgical procedures. Results showed that women perceived more risk to cosmetic surgery, yet held more positive attitudes and desire to spend on cosmetic surgery compared to men. For both men and women, IC predicted positive attitudes and desired spending on cosmetic surgery. Social comparison mediated all relationships between IC and cosmetic surgery variables. Cosmetic surgery is discussed as a potential form of intrasexual competition rooted in the mate-preferences of the opposite sex.