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Objective : Athlete burnout remains a significant concern in competitive sports, with growing evidence highlighting its detrimental effects on performance and mental health. This study examined the efficacy of a Choice Theory-based intervention in reducing burnout symptoms by enhancing autonomy and psychological need satisfaction among elite athletes. Method: Using a longitudinal, randomized controlled design, 156 elite athletes (aged 18–32) from endurance, team, and skill-based sports were allocated to either an 8-week Choice Theory intervention group or a control group receiving standard mental skills training. The intervention incorporated weekly workshops on need identification, cognitive restructuring ("choose to" vs. "have to" thinking), and autonomy-supportive goal setting, alongside coach training in autonomy-supportive communication. Burnout was assessed using the Athlete Burnout Questionnaire (ABQ), while psychological needs were measured via the Basic Psychological Needs Satisfaction in Sport Scale (BPNSSS). Physiological markers (salivary cortisol, heart rate variability) provided objective stress indicators. Results : Results demonstrated significant reductions in emotional exhaustion (p < 0.01, d = 0.72) and sport devaluation (p < 0.05, d = 0.54) in the intervention group compared to controls at 12-month follow-up. Mediation analysis revealed that increased autonomy (β = -0.38, p < 0.001) and competence (β = -0.29, p < 0.01) fully mediated burnout reduction. Physiological data corroborated these findings, with improved HRV recovery (p < 0.05) and lower cortisol levels (p < 0.01) in the intervention group. Conclusions : These findings support Choice Theory as an effective framework for athlete burnout prevention, emphasizing the critical role of autonomy-supportive environments in sustaining long-term athlete well-being. The study advances current practice by demonstrating that structural changes in coaching approaches—particularly empowering athletes with meaningful choices—can significantly mitigate burnout risk. Future research should explore the generalizability of these effects across diverse athletic populations and cultural contexts.