The third Olympiad, like the second, was also combined with the World's Fair, this time in St. Louis in 1904. American participation at the games was extremely lopsided, with less than half of the Games' 94 events featuring non-American athletes. The St. Louis Games marked the first time gold, silver and bronze medals were awarded and the first time boxing and freestyle wrestling were a part of the competition.

Despite having a wooden leg, U.S. gymnast George Eyser claimed six medals, three of them gold, while Anton Heida, another American gymnast, claimed an additional six, five of which were gold. Owing to the paucity of international competition at the Games, the U.S. won the medal count by a landslide, claiming a total of 239. Germany came in second with 13.