Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are commonly performed surgeries aimed at relieving pain and restoring function in patients with severe joint damage. As more active patients undergo these procedures, understanding the implications for postoperative sports participation is critical. Advances in surgical approach have more influence on early recovery and sports ability for THA compared with TKA, while technical advances, i.e., 3D implants and robotic arm-assisted surgery, have more impact on TKA outcome compared to THA. Both joint replacements profit from unconstrained designs and cementless-biologic fixation, and preoperative mental and physical preparation, and should follow a staged postoperative rehabilitation program including individualized physical therapy and telerehabilitation. In general, low to moderate impact sports are recommended for all patients, but individualized programs can enable return to high-impact sports for patients with THA and TKA. Finally, this chapter outlines recommendations and guidelines for sports participation postarthroplasty based on scientific evidence.