Abstract Body (Do not enter title and authors here): Takotsubo syndrome (TTS) is a rare cardiovascular condition characterized by reversible ventricular dysfunction and a presentation resembling that of acute myocardial infarction. An increasing number of studies has shown physical stress as a trigger for TTS. Here, we comprehensively reviewed the literature and examined the available evidence for TTS patients triggered by sports. After searching PubMed, Embase, Web of Science and Scopus databases, two investigators independently reviewed 837 studies published through July 24, 2023. Of these studies, 21 met the inclusion criteria (n = 23 patients), including 9 patients with exercise stress test, 14 patients with daily physical activity. In Sports-trigger TTS patients, the most common TTS symptom was dyspnea (69.57%), followed by chest pain (52.17%) and diaphoresis (13.04%). The most common type of TTS was apical, accounting for 69.57% of cases, followed by the midventricular (21.74%) and basal (8.70%) types. The overall mortality rate for Sports-trigger TTS patients was 0.00%. Exercise stress test (39.13%), swimming (21.74%) and diving (21.74%) are the most frequently identified physical activity triggers of TTS. Sports is a potential etiology of TTS patients, rare but it is associated with excellent prognosis. Furthermore, the diagnosis of TTS must be considered in patients with typical symptom after sports. Future prospective studies are needed to establish appropriate guidelines for avoiding TTS during sports and the appropriate exercise prescription for Sports-trigger TTS patients to recovery.