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Social media (SM) are socio-technical systems that have the potential to provide real-time information during crises and thus to help protect lives and property. Yet, US emergency management (EM) agencies do not extensively use them. This mixed-methods study describes the ways SM is used by county-level US emergency managers, barriers to effective SM use, and recommendations to improve use. Exploratory interviews were conducted with US public sector emergency managers to elicit attitudes about SM. This was followed by a survey of over 200 US county level emergency managers. Results show that only about half of agencies use SM at all. About one quarter of agencies with formal policies actually forbid the use of SM. For both disseminating (sending out) and collecting information lack of sufficient staff is the most important barrier. However, lack of guidance/policy documents is the second highest rated barrier to dissemination via SM. Lack of skills and of the training that could improve these skills is also important. For collecting data, trustworthiness and information overload issues are the second and third most important barriers, which points to the need for appropriate software support to deal with these system-related issues. There are few differences associated with agency characteristics. By understanding important barriers, technologists can better meet the needs of emergency managers when designing SM technologies.