Bathroom access and use in conjunction with biological urge to void is an important part of optimal bladder health. School settings are uniquely positioned to influence the development of bladder habits. The aim of this study was to identify barriers and facilitators to high school bathroom use for adolescent women. A qualitative study design was used to conduct semi-structured interviews focused on experiences with bathroom use while at school. Thirty adolescent women were interviewed, and transcripts were analyzed using thematic analysis methods. Barriers included unpleasant bathroom environments, lack of privacy, and school/teacher policies. Facilitators included clean, private bathrooms and menstruation. Improving bathroom cleanliness, privacy, and eliminating policies aimed at controlling bathroom access may reduce barriers to bathroom use. School nurses have a unique role in educating teachers, administrators, and students about the importance of clean bathrooms and policies that support bathroom use in conjunction with biological urge.