Objective: This study aimed to evaluate the effectiveness of preoperative anxiety management strategies in athletes undergoing day surgery and their impact on postoperative recovery and return to physical activity. Methods: In this randomized controlled trial, 300 athletes scheduled for day surgery were recruited and divided into two groups: an experimental group and a control group, with 150 participants in each. The experimental group received a comprehensive preoperative anxiety management strategy, including sports-specific disease education, psychological counseling, relaxation skills training, preoperative simulation education, family involvement, and meticulous preoperative care. The control group received standard preoperative care. Key outcome measures, including anxiety levels (assessed using the Hamilton Anxiety Scale), heart rate, blood pressure, blood oxygen levels, sleep quality, pain perception, and postoperative recovery time, were analyzed to evaluate the effectiveness of the intervention. Results: The experimental group showed significant improvements across all measured indicators compared to the control group. Specifically, the experimental group experienced a marked reduction in anxiety levels, heart rate, and blood pressure. Additionally, athletes in the experimental group reported improved sleep quality, reduced pain perception, and a shortened postoperative recovery time, facilitating a quicker return to physical activity. Conclusions: The preoperative anxiety management strategy designed for athletes undergoing day surgery proved to be highly effective. This strategy not only reduced preoperative anxiety and enhanced sleep quality but also minimized pain perception and accelerated postoperative recovery, allowing athletes to return to their sports activities sooner. The implementation of this strategy is recommended for broader use among surgical patients, particularly athletes, to enhance preoperative anxiety management and improve postoperative outcomes.