Myasthenia gravis (MG) is an autoimmune disorder of the postsynaptic membrane that leads to severe fatigability and weakness of the proximal muscle groups. This disorder has a peak presentation age that is common in sporting populations. Due to improved treatment strategies, it would not be uncommon for sports medicine physicians to be faced with a myasthenic patient on initial diagnosis or to be consulted regarding activity recommendations. There has been a scarcity of exercise-related research in MG compared to other neuromuscular disorders. There are also no guidelines on clearance issues for active athletes with MG. This article will review the literature and case reports regarding MG in athletics and attempt to help guide recommendations for activity and exercise therapy.