Osteoarthritis is a leading cause of disability worldwide. The most common and relevant reported risk factors for osteoarthritis are: age, female gender, obesity, occupation, previous trauma or injuries, lower extremity malalignment, and sports participation. Despite sports participation has been associated with psychological, social, and health benefits, several studies have identified a relationship between sports and osteoarthritis, especially at higher levels. The present book chapter is aimed to provide a comprehensive review of the literature regarding the risk of lower extremity osteoarthritis with sports participation.