Tristram Shandy has been adapted as a graphic novel by cartoonist Martin Rowson. Michael Nyman has worked sporadically on Tristram Shandy as an opera since 1981. At least five portions of the opera have been publicly performed and one, "Nose-List Song", was recorded in 1985 on the album, The Kiss and Other Movements.
The book was adapted on film in 2006 as A Cock and Bull Story, directed by Michael Winterbottom, written by Frank Cottrell Boyce (credited as Martin Hardy, in a complicated metafictional twist), and starring Steve Coogan, Rob Brydon, Keeley Hawes, Kelly Macdonald, Naomie Harris, and Gillian Anderson. The movie plays with metatextual levels, showing both scenes from the novel itself and fictionalised behind-the-scenes footage of the adaptation process, even employing some of the actors to play themselves.
In February 2014, a theatrical adaptation by Callum Hale was presented at the Tabard Theatre in Chiswick.
Tristram Shandy has been translated into many languages, including German (repeatedly, beginning in 1769), French (repeatedly, beginning in 1785; by Guy Jouvet, 2004), Hungarian (by Győző Határ, 1956), Italian (by Antonio Meo, 1958), Czech (by Aloys Skoumal, 1963), Spanish (by José Antonio López de Letona, 1975; Ana María Aznar, 1976 and Javier Marías, 1978), Portuguese (by José Paulo Paes, 1984), Norwegian (by Bjørn Herrman, 1995–96), Finnish (by Kersti Juva, 1998) and Dutch (by Jan & Gertrude Starink, 1990).