After being present as observers in the 2019 Games of the Small States of Europe and as guests in the 2022 Championships of the Small States of Europe, the delegation was invited by local organizers to compete in the 2022 Mediterranean Games and fielded one athlete in the sport of athletics, who competed in the women's half marathon.

[2] They were then scheduled to officially compete at the 2021 Games of the Small States of Europe held in Andorra la Vella, Andorra, through a partnership with the Italian Olympic Committee signed in 2018,[3] but the event was cancelled due to the COVID-19 pandemic and to avoid scheduling conflicts with the 2020 Summer Olympics, which were rescheduled to be held in 2021 in Tokyo, Japan.

The delegation consisted of three people: the head of the Vatican's sports department in the culture ministry, Melchor Sánchez de Toca Alameda [es]; runner Sara Carnicelli, who got eligibility to represent the Vatican through her mother being an employee as an administrative worker in the nation;[10] and runner Simone Adamoli, who was also set to compete but withdrew before his event.

[9] Following Adamoli's withdrawal from his event, the Vatican's sole athlete, Sara Carnicelli, competed in the women's half marathon alongside competitors such as Olympians Rkia El Moukim from Morocco, Souad Aït Salem from Algeria, and eventual winner Giovanna Epis from Italy.

Her event started on July 1 at the Miloud Hadefi Stadium, and she eventually ended the race in 1:17:21, placing ninth unofficially.