Sale's elbow injury is still a concern, and it's unknown for how long the left-hander will be sidelined, but the surgery would have ended his season before it began.
Elbow inflammation forced Sale to be shut down in August, during the Red Sox's 84-78 season. He finished 6-11 with a 4.40 ERA. His five-year, $145 million extension with Boston starts this season.
The Athletic first reported that Sale is not expected to have Tommy John surgery.
As the Red Sox pondered Sale's future, they gathered several medical opinions. Interim manager Ron Roenicke told reporters earlier Wednesday that the team was still waiting to hear from renowned surgeon Dr. Neal ElAttrache.
Roenicke stressed that the Red Sox needed "to get this right" before determining how to proceed with Sale.
ElAttrache was the third medical expert to review the MRI on Sale's elbow, along with surgeon Dr. James Andrews and the Red Sox's medical staff.
"We want as many opinions as we can," Roenicke said. "Dr. Andrews saw it and read the MRI. I don't want to comment on it until we get one more opinion."
Sale saw Andrews in August after the seven-time All-Star was shut down. Sale had a platelet-rich plasma injection at the time but avoided surgery.
Sale, who turns 31 on March 30, threw to batters Sunday for the first time since August and told the team of the soreness in his elbow Monday.
The Red Sox had already said that Sale would start the season on the injured list after he reported to camp with pneumonia.