Purpose: This study aimed to evaluate the effectiveness of CT-guided minimally invasive open surgery for treating osteoid osteoma (OO) in athletes, focusing on its clinical safety and efficacy. Methods: We reviewed medical records and imaging data of 14 athletes treated for OO from January 2014 to December 2018 using intraoperative CT-guided mini-open resection. Variables such as operation time, blood loss, incision length, and visual analogue scale (VAS) scores were analyzed to assess the outcome. Results: All 14 athletic patients, predominantly male with an average age of 21, underwent successful tumor removal, confirmed by pathological examination. Over an average follow-up of 37.9 months, significant improvements in pain were recorded, with no complications or recurrences related to the procedure. The mean operation metrics included a time of 27.8 minutes, blood loss of 31.1 ml, and incision length of 3.6 cm. The mean postoperative VAS scores significantly decreased, indicating effective pain management. Conclusion: CT-guided open surgery proved to be a safe and effective method for managing OO in athletes, enhancing recovery and return to sports activity without significant complications. This approach provides a viable option for surgeons treating athletes affected by this condition.