While professional boxing is subject to some federal regulation, there is still a call for greater uniformity throughout the states. For example, the variation of state procedures for performance-enhancing drug and post-fight neurological testing present a serious threat to an athlete’s health that can lead to physical impairments or even death. I argue professional boxing regulation should be completely uniform, left to the federal government rather than individual states. I review the regulatory system in professional boxing and show how the lack of uniformity leads to undesirable health, safety, and business practices. Founded on a critical analysis of federalism, the argument is based on a general consideration of when public policy in the United States should be uniform and when it should be left for states to decide.