Background: Modified radical mastectomy remains a prevalent surgical approach for treating breast cancer, with remifentanil and propofol serving as cornerstone anesthetics due to their efficacy. Their impact on the postoperative recovery of athletes, who require rapid return to physical activities, is of particular interest. Methods: This study involved 100 patients who underwent modified radical mastectomy following neo adjuvant chemotherapy. They were divided into two groups: one receiving remifentanil (n=50) and the other a combination of remifentanil and propofol (n=50). Outcomes assessed included recovery times, pain levels, complication rates, and clinical indicators, with a special focus on metrics significant to athletes' physical rehabilitation. Results: The compound anesthesia group showed significantly shorter onset times for anesthesia, consciousness recovery, extubation, and respiratory satisfaction compared to the remifentanil-only group (P<0.05). Additionally, visual analog scale (VAS) scores and agitation levels were substantially lower, and complication rates were reduced (26% vs. 56%, P<0.05). Postoperative immune function indexes and intraoperative hemodynamic stability also favored the compound anesthesia group. Notably, recovery times for respiratory function and directional force, crucial for athletes, were significantly shorter in the compound group (P<0.05). Conclusion: The combination of remifentanil and propofol for target-controlled infusion anesthesia significantly enhances postoperative recovery, reduces complication rates, and ensures greater stability in clinical indicators relevant to athletes. These findings support the preference for compound anesthesia in surgeries for athlete patients, optimizing their rehabilitation process and hastening their return to training and competition.