Women are presumed to compete intrasexually primarily on the basis of physical attractiveness. As such, in efforts to enhance their appearance, women may strive to achieve unrealistic cultural ideals of attractiveness promulgated in the media with potentially negative implications (e.g., body dysmorphic disorder, eating disorders, and cosmetic surgery). The present study considered the implications of two forms of competitive orientation on women’s acceptance of cosmetic surgery. Findings indicated that a hypercompetitive orientation (psychologically unhealthy) was a better predictor of acceptance of cosmetic surgery than body dysmorphia. Personal development competitiveness (psychologically healthy) was not related to either body dysmorphia or cosmetic surgery acceptance. Implication of these results and direction for further research are considered.