He has competed in every Summer Paralympic Games from 1976 to 2008, winning an incredible total of fourteen gold, six silver, and two bronze medals. All of these medals were for athletics, except for one bronze earned in hand-cycling at the 2004 Games. At the 2008 Beijing Games, Nietlispach competed only in cycling; this was the first time he appeared at the Paralympics without participating in an athletics event. He also competed in table tennis early in his career, taking part in that sport at the 1976 and 1980 Paralympics.