The expectations of total joint replacement are constantly increasing: Freedom of pain and mobility used to be the primary goal, while nowadays it is longevity despite heavy loading and intense sporting activity. A preoperative sportive patient expects to be able to perform his favorite sporting activities like hiking, swimming and cycling, but also the more demanding skiing, tennis and jogging, for example, after surgery. The aim of this article is to illustrate what level of sporting activities can be performed by patients with total joint replacement. Are there differences between the pre- and postoperative levels? What are the risks for, and negative influences on, the prosthesis during intense sporting activity? What is the role of the physician? Finally, recommendations for sporting activities after total hip and knee replacement are given.