This study aimed to analyze whether there are differences and associations in the physical responses in international-level cerebral palsy footballers between official matches and 2v2 small-sided games (2v2-SSG). One hundred seventy international cerebral palsy footballers participated in this study during three international championships. The physical responses of mean and maximum velocities, total distance, distance covered at different intensities, short-term actions, and player load were collected during 2v2-SSG and the real competition. The mean velocity, total distance, jogging, medium- and high-intensity distances, the number of moderate/high accelerations, decelerations, and player load were relatively higher in the 2v2-SSG than in the official matches. Even though the 2v2-SSG could become an appropriate drill to include during the classification process, due to the differences between a 2v2-SSG and the official competition, it is necessary to deepen the scientific knowledge for developing observation methods during real competition to strengthen the relationships between eligible impairments and activity limitation.