The phenomenon of placebo and expectation effects in sports medicine is a subject of intense debate, marked by conflicting perspectives and discussions over the last decades. Despite significant advancements in placebo research within this field, defining the placebo and its effects is complex. A placebo is generally understood as a sham medical treatment, and placebo effects encompass positive physical or psychological outcomes following such treatment, contingent upon the attached expectations. Expectations emerge as the pivotal determinant of placebo effects, emphasizing their significance. Conversely, the nocebo effect introduces negative expectations or beliefs about an intervention, resulting in adverse outcomes, even when the treatment lacks direct physiological impact. Simplistically, the placebo effect yields positive results, while the nocebo effect yields negative outcomes. The complexity of the placebo effect is underscored by variations in responsiveness, where individuals responding positively are termed “responders.” These individuals experience symptom improvement due to psychological factors like positive expectations despite the treatment lacking specific therapeutic effects. Conversely, non-responders do not exhibit a significant positive response to the placebo treatment. In sports medicine, researchers, and practitioners must meticulously consider these placebo and expectation effects when designing interventions for athletes. It is crucial to recognize that the ethical implications of employing placebos in sports medicine demand scrutiny.