There is little knowledge about within- and between-referee variation (WBRV) in cardiovascular responses (CVR) and locomotor game demands (LMD). Thus, the primary aim of this study was to assess the WBRV of CVR and LMD in male basketball referees during elite international games in preparation [e.g., warm-up (WU) and re-warm-up (R-WU)] and active game phases. The secondary aim was to explore quarter-by-quarter differences in CVR and LMD. Thirty-five international male referees took part in this study (age, 40.4 ± 5.4 years; body height, 184.9 ± 5.7 cm; body weight, 85.1 ± 7.5 kg; BMI, 24.0 ± 1.7 kg × m−2; fat%, 18.8 ± 4.7% and VO2max, 50.4 ± 2.2 L × kg−1 × min−1. In total, 76 games (e.g., 228 officiating cases) were analyzed during the FIBA elite men’s competition. They officiated 4.5 games on average (range 3–9 games). Each referee used the Polar Team Pro system to measure CVR [e.g., heart rate (HR), time spent in different HR intensity categories] and LMD (e.g., distance covered, maximal and average velocity, and number of accelerations). Results showed that the referees had bigger WBRV during the active and preparation (e.g., W-U than R-WU) phase when variables of higher CVR and LMD intensity were observed (e.g., time spent at higher HR zones, distance covered in higher speed zones). The WBRV, CVR, and LMD were higher during WU than R-WU. Moreover, the referees had a lower CVR and LMD in the second half. In conclusion, the referees should establish and follow consistently a game-to-game preparation routine and attempt to spread their on-court preparation time equally within the crew. A half-time preparation routine should be improved to re-establish a sufficient activation level similar to that achieved in pre-game preparation.