Research has shown mixed results regarding students' preferences of digital over printed textbooks. However, none of the published studies have studied physical therapy students and few have surveyed students across more than one professional program. The purpose of this study was to identify the perceptions and use of digital textbooks and printed textbooks by students in four different physical therapy programs.We surveyed first-, second-, and third-year physical therapist students from four physical therapy programs in different regions of the United States. Descriptive statistics were used to report the students' responses. Chi square tests of independence were used for all comparisons between genders and years in the program with a=0.05.More students had purchased or leased printed textbooks than digital textbooks. Students preferred digital textbooks for portability, cost, and search ability. Students preferred printed textbooks for studying and preparing for examinations. Printed textbooks were preferred for readability, comprehension, retention, and studying and were less tiring on the eyes. Males preferred digital textbooks and females preferred printed textbooks. Students in Years 2 and 3 of the programs preferred digital textbooks, and students in Year 1 preferred printed textbooks for some features.Students preferred digital textbooks for convenience factors and printed textbooks for learning.