The prevalence of low back pain varies by sport, age, and gender, with some sports like gymnastics and wrestling showing higher rates of spinal issues. Low back pain is one of the most common reasons for lay-off time in athletes and can be severe enough to interfere with training and competition. The complex structure of the spine, especially the intervertebral discs, undergoes degeneration with age and sports activities, making athletes more susceptible to injuries. This chapter discusses low back pain in athletes, particularly its prevalence, causes, and impact on athletic performance, but also explores the biomechanics of different sports, the anatomy of the spine, and the impact of degenerative changes, which lead to long lasting pain. Finally, the chapter outlines prevention strategies, diagnosis, treatment options, and post-surgical recovery plans for athletes suffering from low back pain.