American football, known simply as football in the United States of America and Canada, is a human competitive team sport. Outside the United States and Canada, the game is called American football to differentiate it from soccer, which is often called football as well. In football, the object of the game is to move the ball, called a football, into an opposing team's end zone, while preventing the opposing team from doing the same. The game was one of the most popular spectator sports in the United States.

On board the ECS Fortunate, Captain Keene and first officer Matthew Ryan would often pass the time throwing a football back and forth to each other across one of the Fortunate's cargo modules. Because the cargo modules were a low gravity area, the two men were able to throw a football a considerably greater distance than they would be able to otherwise - Keene noted that on Earth Ryan probably could not even throw the ball ten meters. (ENT episode: "Fortunate Son")

While professional baseball had died out on Earth by the 2040s, professional football continued to be played on Earth well into the 22nd century. At some point a cultural observer from Vulcan witnessed a football game and then reported that the other players were trying to kill the quarterback. The Vulcan Kov had read the report, and asked Trip Tucker about the game. Tucker corrected Kov's misconceptions about the game, stating that the opposing team was only trying to prevent the quarterback from passing the ball or running it down the field. (ENT episode: "Fusion")

As a young man, Fleet Captain Christopher Pike was the captain of his high school's football team. (TOS novel: Burning Dreams)

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