Purpose: This study examined performance and physiological adaptations following 3 weeks of repeated-sprint training (RST) with blood-flow restriction (BFR) or without (non-BFR). Methods: Twenty-six semiprofessional and amateur adult male team-sport players were assessed for repeated-sprint ability, anaerobic capacity, leg lean mass, neuromuscular function, and maximal aerobic capacity before and after RST. Participants completed 9 cycling RST sessions (3 sets of 5–7 × 5-s sprints, 25-s passive recovery, 3-min rest) over a 3-week period with BFR or non-BFR. Results: During RST sessions, the BFR group demonstrated lower mean power output compared with non-BFR (−14.5%; g = 1.48; P = .001). Significant improvements (P < .05) in mean and peak power output during repeated-sprint ability (+4.1%; g = 0.42, and + 2.2%; g = 0.25, respectively) and anaerobic capacity (+4.8%; g = 0.47, and + 4.7%; g = 0.32, respectively) tests, leg lean mass (+2.0%; g = 0.16), and peak aerobic power (+3.3%; g = 0.25) were observed from pretesting to posttesting without any between-groups differences. No significant changes (P > .05) were observed for maximal isometric voluntary contraction and maximal aerobic capacity. Peak rate of force development decreased (P = .003) in both groups following RST (−14.6%; g = 0.65), without any between-groups differences. Conclusions: Repeated-sprint ability, anaerobic capacity, leg lean mass, and peak aerobic power improved following 3 weeks of RST; however, the addition of BFR did not further enhance adaptations. Interestingly, comparable improvements were achieved between groups despite lower external loads experienced during RST sessions with BFR.