There are no major league professional sports teams in Kentucky. There is a minor league baseball team in Louisville that plays in the Triple-A International League. There are also two minor league hockey teams in Kentucky that play in the American Hockey League.

The first known horse race in Kentucky was held in 1783. The annual Kentucky Derby, first run on 17 May 1875, has become the single most famous event in US thoroughbred racing. Held on the first Saturday in May at Churchill Downs in Louisville, the Derby is one of three races for three-year-olds constituting the Triple Crown. Keeneland Race Course in Lexington is the site of the Blue Grass Stakes and other major thoroughbred races. The Kentucky Futurity, an annual highlight of the harness racing season, is usually held on the first Friday in October at the Red Mile in Lexington.

Rivaling horse racing as a spectator sport is collegiate basketball. The University of Kentucky Wildcats, who play in the Southeastern Conference, won NCAA Division I basketball championships in 1948–49, 1951, 1958, 1978, 1996, and 1998, and the National Invitation Tournament in 1946 and 1976. The University of Louisville Cardinals, who play in Conference USA, captured the NCAA crown in 1980 and 1986, and won an NIT title in 1956. Kentucky Wesleyan, at Owensboro, was the NCAA Division II titleholder in 1966, 1968–69, 1973, 1987, 1990, 1999, and 2001.