Context: Recent findings suggests that athletes have enhance pain modulatory systems compared to non-athletes, despite being constantly subjected to painful stimuli through training and competition. Measurements such as conditioned pain modulation (CPM) is one test that we can use to compare modulatory pain processes. CPM has been shown to be different in non-athlete males and females, but to our knowledge, no study has examined the sex differences in CPM in athletes. In addition, psychological factors, including pain catastrophizing, may explain why athletes perceive and express pain differently. Objective: To compare the sex differences in pain ratings, pressure pain threshold (PPT), and cardiovascular variables in athletes during a CPM protocol; and to determine influence of pain catastrophizing and other psychological factors with pain and cardiovascular variables recorded during a CPM protocol. Design: Cross-sectional design. Setting: Laboratory. Participants:  120 athletes (60 females) from various sports participated in this study. Main Outcome Measures: We measured catastrophizing using the Pain Catastrophizing Scale and pain using an 11-point numeric pain rating scale. CPM was measured using pressure pain threshold (PPT), which was measured on the thenar eminence and tibialis anterior before and after a cold pressor test (CPT). Results: During the CPT, participants experienced increases in subjective pain ratings, but pain intensity did not differ between males and females. We observed increases in PPT measures following the CPT in males and females, but males displayed higher PPT measures than females at pre- and post-CPT. In addition, we did not identify a relationship between any psychological factors and subjective pain ratings during the CPT. Conclusions: Our results suggest that psychological factors do not influence pain perception during a CPT and that male athletes present greater PPT measures than female athletes.