The Cotswold Olympic Games, a sports festival which emerged in 17th century England, featured athletics in the form of sledgehammer throwing contests. Annually, from 1796 to 1798, L'Olympiade de la République was held in revolutionary France, and is an early forerunner to the modern Olympic Games. The premier event of this competition was a running event, but various ancient Greek disciplines were also on display. The 1796 Olympiade marked the introduction of the metric system into the sport.

Athletics competitions were held about 1812 at the Royal Military College, Sandhurst, and in 1840 in Shrewsbury, Shropshire at the Royal Shrewsbury School Hunt. The Royal Military Academy at Woolwich held an organised competition in 1849, and a regular series of closed meetings open only to undergraduates, was held by Exeter College, Oxford, from 1850. The annual Wenlock Olympian Games, first held in 1850 in Wenlock, England, incorporated athletics events into its sports programme.

The first modern-style indoor athletics meetings were recorded shortly after in the 1860s, including a meet at Ashburnham Hall in London which featured four running events and a triple jump competition.

The Amateur Athletic Association (AAA) was established in England in 1880 as the first national body for the sport of athletics and began holding its own annual athletics competition – the AAA Championships. The United States also began holding an annual national competition – the USA Outdoor Track and Field Championships – first held in 1876 by the New York Athletic Club. Athletics became codified and standardized via the English AAA and other general sports organisations in the late 19th century, such as the Amateur Athletic Union (founded in the US in 1888) and the Union des sociétés françaises de sports athlétiques (founded in France in 1889).

An athletics competition was included in the first modern Olympic Games in 1896 and it has been one of the foremost competitions at the quadrennial multi-sport event ever since. Originally for men only, the 1928 Olympics saw the introduction of women's events in the athletics programme. Athletics is part of the Paralympic Games since the inaugural Games in 1960. Athletics has a very high profile during major championships, especially the Olympics, but otherwise is less popular.

An international governing body, the International Amateur Athletics Federation (IAAF), was founded in 1912. It enforced amateur sport status on competitions during much of the 20th century. Professional competition continued at a low level, becoming increasingly more common as the century progressed. The International Track Association briefly formed a professional track and field circuit in the United States in the 1970s. Athletes used their increasing status to push for remuneration and the IAAF responded with the IAAF Golden Events series and the establishment an outdoor World Championships in 1983, including track and field, racewalking and a marathon event. In modern times, athletes can receive money for racing, putting an end to the so-called "amateurism" that existed before. The global body updated its name to the International Association of Athletics Federations in 2001, moving away from its amateur origins, before taking on its current name World Athletics in 2019.

The Comité International Sports des Sourds had been formed by 1922, to govern international deaf sports, including athletics.

The first organized international competitions for athletes with a physical disability (not deaf) began in 1952, when the first international Stoke Mandeville Games were organized for World War II veterans. This only included athletes in a wheelchair. This inspired the first Paralympic Games, held in 1960. Competitions would over time be expanded to include mainly athletes with amputation, cerebral palsy and visual impairment, in addition to wheelchair events.