According to the American Society of Plastic Surgeons (2007), the number of cosmetic procedures has increased to over 10 million in 2006, representing a 48% increase from 2000. This increase in cosmetic surgery prevalence is paralleled by a surge in reality cosmetic surgery television programming. The current study examined the relationships among cosmetic surgery reality TV viewership, cosmetic surgery attitudes, body image, and disordered eating in a sample of 2057 college women. Viewership of reality cosmetic surgery shows was significantly related to more favorable cosmetic surgery attitudes, perceived pressure to have cosmetic surgery, past attainment of a cosmetic procedure, a decreased fear of surgery, as well as overall body dissatisfaction, media internalization, and disordered eating. Although the current study is correlational, it provides a framework for future hypothesis testing and elucidates the link between contemporary media influences, body dissatisfaction, disordered eating, and cosmetic surgery attitudes. Additionally, the findings indicate that surgeons may want to assess the relevance of cosmetic surgery reality TV viewership for patients' attitudes towards and expectations about cosmetic surgery.