Pearson, J, Wadhi, T, Barakat, C, Aube, D, Schoenfeld, BJ, Andersen, JC, Barroso, R, Ugrinowitsch, C, and De Souza, EO. Does varying repetition tempo in a single-joint lower body exercise augment muscle size and strength in resistance-trained men? J Strength Cond Res XX(X): 000–000, 2021—This study compared the effects of FAST and SLOW eccentric repetition tempo in a single exercise volume-matched intervention on muscle thickness (MT) and strength in resistance-trained men. Using a within-subject design, 13 subjects had each leg randomly assigned to SLOW (1-0-3) or FAST (1-0-1) repetition tempo. Subjects underwent an 8-week strength-training (ST) intervention performed twice weekly. Unilateral leg-extension one repetition-maximum (1RM) and anterior thigh MT at the proximal (MTP) and distal (MTD) portions were assessed via ultrasound imaging at baseline and after 8 weeks of RT. Rating of perceived exertion (RPE) assessments of the training sessions (i.e., 16 per leg) were averaged for further analysis. Both legs similarly increased MTP (estimated differences: FAST: 0.24 cm, 3.6%; SLOW: 0.20 cm, 3.1%). However, for MTD, analysis of covariance analysis showed a leg effect (p = 0.02) in which absolute pre-to-post change was greater in FAST compared with SLOW (estimated differences: FAST 0.23 cm, 5.5%; SLOW: 0.13 cm, 2.2%). For 1RM, both legs similarly increased maximum strength (estimated differences: FAST: 9.1 kg, 17.0%; SLOW: 10.4 kg, 22.1%, p ≤ 0.0001). The SLOW group had a higher RPE than FAST (8.59 vs. 7.98, p = 0.002). Despite differences in RPE, our results indicate that both repetition tempos produced similar muscular adaptations. However, they also suggest that the FAST tempo may provide a small hypertrophic advantage at the distal quadriceps. From a practical standpoint, strength and conditioning professionals may implement a FAST tempo at least in one single-joint exercise during an 8-week training period to enhance regional hypertrophic adaptations in trained individuals.