Low back pain (LBP) is a prevalent condition among athletes, often arising from the unique biomechanical and physiological demands of sports. This chapter explores the multifactorial etiology of LBP in athletes, including pathoanatomical, physical, lifestyle, and psychological risk factors. We discuss the specific biomechanical mechanisms behind common sports-related injuries such as spondylolysis, lumbar disc herniation, and spondylolisthesis, emphasizing the role of sport-specific movements and training loads. We present a five-phase rehabilitation framework, targeting pain resolution, restoration of range of motion, strength, coordination, and sport-specific skills. Return-to-sport (RTS) criteria emphasize a gradual progression and holistic recovery, addressing physical, psychological, and performance-related dimensions. Prevention strategies, tailored to the demands of different sports, are proposed to mitigate LBP incidence and recurrence. This comprehensive approach underscores the importance of multidisciplinary management and individualized care in enhancing athlete recovery and prolonging their careers.