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OBJECTIVE To determine the prevalence of tramadol prescribing among commercially insured adults receiving medication-assisted therapy (MAT) with buprenorphine/naloxone. DESIGN The authors conducted a cross-sectional descriptive study to evaluate the use of tramadol among patients prescribed buprenorphine/suboxone for MAT. SETTING This study utilized data from 2010 to 2013 Optum® Clinformatics® Data Mart. This cohort is an administrative health claims database from a large national insurer. These data included pharmacy and medical care utilization and information describing patient enrollment. PATIENTS/PARTICIPANTS Patients were 12-64 years of age and had complete and available medical, pharmacy, and administrative records in the Optum Clinformatics Data Mart during the study period. MAIN OUTCOME MEASURES Patients who received at least one paid claim for buprenorphine/naloxone from 2010 to 2013 and also received at least one overlapping pharmacy dispensing for tramadol were identified for analysis. The authors determined if the concurrent buprenorphine/naloxone and tramadol dispensings were from the same or a different prescriber. RESULTS In this analysis of 18,734 US commercially insured patients receiving MAT with buprenorphine/naloxone, the authors identified 1,198 (6.4 percent) patients who received at least one overlapping dispensing for tramadol during a 4-year period spanning 2010-2013. Among these patients, 266 (1.42 percent) were co-prescribed buprenorphine/naloxone and tramadol from the same provider. CONCLUSIONS These results suggest that the use of tramadol among patients receiving buprenorphine/naloxone is not uncommon. Further study is warranted to further determine the benefits and risks associated with the use of tramadol for pain management among patients prescribed buprenorphine/naloxone.