Sports injuries often involve tendons, muscles and ligaments. The variable outcome of surgery and medical treatment support early functional treatments. Eccentric exercise (EE) displayed effectiveness in the management of Achilles tendinopathy (AT), patellar tendinopathy (PT) and lateral epicondyle tendinopathy (LET). Preliminary results of EE in other tendinopathies and sports injuries suggest its wide prescription in the sport rehabilitation field. A comprehensive search of PubMed, Web of Science, the Cochrane Collaboration Database, Physiotherapy Evidence Database (PEDro), Evidence Based Medicine (EBM) Search review, National Guidelines, Scopus and Google Scholar was performed using keywords such as ‘eccentric exercise’, ‘sports injuries rehabilitation’, ‘tendinopathy’, ‘hamstrings strain’ ‘adductor injuries’ and ‘ACL reconstruction rehabilitation’. EE, on their or associated with other therapies, represents a feasible, cost-effective and successful tool in the treatment of well-known targets and might have potential in shoulder tendinopathy, adductor-related groin pain, hamstring strains, and ACL rehabilitation. The inadequacy of standardization of protocols, the variable amount, quality and follow-up of studies, the different anatomy and pathophysiology of the therapeutic targets limit the evidence of applicability of EE to sports injuries. The pats pladed pathology and biomechanics in the response to EE should receive additional investigation. New randomized controlled trials ought to test the effectiveness of standardized EE regimens to various sites of sports injuries.