No event in history caused a global disruption in all levels of sport as did the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, hereafter referred to as COVID-19). Wars, political boycotts, bans, and the Spanish flu of 1918 affected hosting and event attendance as well as game scheduling, but nothing brought the global sport community to a standstill like COVID-19. Athletes, sport organizations, and fans alike had to adjust to a new reality. This chapter will address the evolution of mental health challenges faced by athletes though the COVID-19 pandemic and novel strategies used by major sport leagues to resume competition in the environment of an ongoing pandemic (including reintroducing sport without live spectators and athletes living in “bubbles”).