Small-sided games (SSGs) are widely used in basketball, yet the specific recovery demands imposed by different SSG formats remain unclear. Therefore, the aim of this study was to compare acute and short-term physiological and neuromuscular responses following scoring-oriented SSG using baskets (SSGbasket), possession-oriented (SSGpossession), and a control condition with no SSGs conducted (CON). Thirty-six trained basketball players completed all three conditions in a randomized crossover repeated-measures design. Salivary creatine kinase (CK), pressure pain threshold (PPT), visual analogue scale (VAS) soreness, and reactive strength index (RSI) were assessed at baseline, post, 24 h, and 48 h. There were significant condition × time interactions for CK (p < 0.001), PPT (p < 0.001), VAS (p < 0.001), and RSI (p < 0.001). CK increased most in SSGbasket, exceeding SSGpossession and CON at 24 h and 48 h (all p < 0.001). PPT decreased significantly at all post-exercise time points in SSGbasket and SSGpossession compared with CON (all p < 0.01), with SSGbasket showing the lowest values at 24 h (p < 0.001). VAS soreness was substantially higher in SSGbasket vs. the other conditions immediately post, at 24 h, and at 48 h (all p < 0.001). RSI decreased significantly from baseline in all formats (p < 0.001), but impairments were largest and most prolonged after SSGbasket compared with SSGpossession and CON (all p < 0.001). In conclusion, scoring-oriented SSGbasket elicits larger changes in salivary CK, soreness, and neuromuscular function than possession-oriented SSGbasket or the control training day used in this protocol, requiring careful scheduling within the basketball microcycle.