Sarah Josephson and her twin sister, Karen, made a formidable duet in synchronized swimming, competing at three Olympic Games and winning multiple international medals. Sarah competed at three Olympic Games, in solo each time and as a duet with her sister in 1988-92. Together they won duet gold at the 1992 Olympics, 1991 World Championships, 1991 Pan Pacific Championships, 1991 World Cups, and at the 1987 Pan American Games. To this they added duet silvers at the 1988 Olympics, 1986 Worlds, and the 1985 and 1987 World Cups. Sarah also won team gold medals at the 1991 World Championships, 1991 Pan Pacs, and the 1987 Pan Ams. Sarah and Karen were seven-times US Champions in the Duet. In solo competition, Sarah won silver medals at the 1986 World Championships and 1985 World Cup. Together they also won nine NCAA Championships.
Sarah Josephson graduated from The Ohio State University with a degree in genetics in 1985. Both sisters attended medical school but dropped out after two semesters. Sarah later became a performance consultant for athletes and businessmen. Sarah was Ohio State University Woman Athlete of the Year in 1984, and is a member of The Ohio State University Athletic Hall of Fame (1993), and the International Swimming Hall of Fame (1997).