We report on extragalactic sources detected in a 455 deg(2) map of the southern sky made with data at a frequency of 148 GHz from the Atacama Cosmology Telescope (ACT) 2008 observing season. We provide a catalog of 157 sources with flux densities spanning two orders of magnitude: from 15 mJy to 1500 mJy. Comparison to other catalogs shows that 98% of the ACT detections correspond to sources detected at lower radio frequencies. Three of the sources appear to be associated with the brightest cluster galaxies of low-redshift X-ray-selected galaxy clusters. Estimates of the radio to millimeter-wave spectral indices and differential counts of the sources further bolster the hypothesis that they are nearly all radio sources, and that their emission is not dominated by re-emission from warm dust. In a bright (> 50 mJy) 148 GHz selected sample with complete cross-identifications from the Australia Telescope 20 GHz survey, we observe an average steepening of the spectra between 5, 20, and 148 GHz with median spectral indices of alpha(5-20) = -0.07 +/- 0.06, alpha(20-148) = -0.39 +/- 0.04, and alpha(5-148) = -0.20 +/- 0.03. When the measured spectral indices are taken into account, the 148 GHz differential source counts are consistent with previous measurements at 30 GHz in the context of a source count model dominated by radio sources. Extrapolating with an appropriately rescaled model for the radio source counts, the Poisson contribution to the spatial power spectrum from synchrotron-dominated sources with flux density less than 20 mJy is C-Sync = (2.8 +/- 0.3) x 10(-6) mu K-2.