With a total of eleven World Championship and Olympic medals, Sacramone is the fourth most decorated U.S. female gymnast, behind Simone Biles (41), Shannon Miller (16), and Nastia Liukin (14).

Later that year, she participated in her first international competition as a senior, the Massilia Gym Cup in Marseille, France, where she placed fourth on floor and ninth on vault.

In 2004, Sacramone helped the U.S. win a team gold medal at the Pacific Alliance Championships in Honolulu and won the individual vault title.

Her performances caught the attention of the media, which began to mention her as a contender for the American team at the 2004 Olympics in Athens.

Although she tied with Mohini Bhardwaj for the silver medal on the vault,[13] she finished in 19th place overall and did not qualify to the Olympic Trials.

[8][14] Sacramone continued competing in late 2004 as a member of the national team and was assigned to several international meets, including the Pan American Individual Event Championships, where she won the vault and floor exercise titles.

[15] At the World Cup Finals in Birmingham, England, she attracted media attention again when she upset reigning Olympic vault champion Monica Roşu of Romania to take first place on the event.

She was named to the American team, along with Nastia Liukin and Chellsie Memmel, for the 2005 World Championships in Melbourne, Australia, where she won a gold medal on floor and placed third on vault.

[18] She qualified as an individual on the floor exercise for the NCAA National Championships, the second Brown gymnast ever to do so, but did not advance beyond the preliminary round.

[19] During the preliminary round at the World Championships, Sacramone qualified for the event finals on floor and vault and contributed to the top-qualifying position of the American team.

However, due to an International Federation of Gymnastics rule allowing only two athletes per country to participate in each event final, Sacramone was unable to compete for a beam medal, because teammates Liukin and Shawn Johnson qualified ahead of her.

[24] Both the Brestyans and the U.S. National Team Coordinator, Márta Károlyi, suggested that Sacramone forgo NCAA competition during the 2007–08 season to concentrate on her preparations for the 2008 Olympics.

[16] In September 2007, Sacramone announced that she was "turning pro" and signed with an agent, forfeiting her remaining NCAA eligibility.

[10] In the 2007–08 academic year, Sacramone continued to work with the Brown gymnastics team as a volunteer assistant coach.

"[31] However, analysts in the gymnastics community, including University of Georgia head coach Suzanne Yoculan, former Olympian John Roethlisberger and International Gymnast editor Paul Ziert, noted that the American team started the competition at a difficult point deficit to the Chinese and that mathematically, Sacramone could not have been personally or exclusively responsible for the U.S. team's results.

She also placed fourth on beam in preliminaries behind Li Shanshan of China, Liukin and Johnson, but did not advance to the eight-person event finals due to the "two per country" rule.

[57][58] In June 2008, Sacramone and her teammates Shawn Johnson and Nastia Liukin became the first female athletes ever to be signed as CoverGirl spokesmodels.

[60] In 2009, she also appeared in a Gatorade commercial that spoofed Monty Python and the Holy Grail as "Alicia, The Girl Who Made Horse Trotting Noises.

"[61] During the summer of 2009, Sacramone briefly stayed in Los Angeles and designed for Tank Farm, a men's fashion company.

Sacramone announced her engagement to former Notre Dame and NFL quarterback Brady Quinn in August 2013 and they married in March 2014.

[68][69] [70] 2002: "Jazz Machine" by Black Machine2003–04: "Explosive" by Bond2005: "Que Locura" by Christian Reyes2006–08: "Santa Maria (Del Buen Ayre)" by the Gotan Project[71]2011: "300 Violin Orchestra" by Jorge Quintero and "Heart of Courage" by Two Steps from Hell[72]