Larry Nassar was charged with molesting seven girls, many of whom are gymnasts, while working for USA Gymnastics and Michigan State University.
As part of the plea deal, the 54-year-old could face at least 25 years in prison.
The hearing comes after a third former US Olympian, Gabby Douglas, accused him of abuse.
In a statement to the court on November 22, Larry Nassar said he was pleading guilty to “move the community forward and stop the hurting”.
He said: “I’m so sorry that this was like a match that turned into a forest fire, out of control.
“I want them to heal. I want this community to heal. I have no animosity toward any one. I just want healing. It’s time.”
Ingham County Court Judge Rosemarie Aquilina said, noting that abuse is a nationwide “epidemic”: “You used that position of trust that you had in the most vile way – to abuse children.
“You violated the oath that you took, which is to do no harm, and you harmed them. Selfishly.”
Many of Larry Nassar’s accusers testified that they were abused while he was examining the young athletes, and sometimes while their parents were nearby.
He has been accused of abusing more than 130 women – including Olympic gold medalists Gabby Douglas, Aly Raisman and McKayla Maroney – during his time as team doctor for the US women’s gymnastics team.
Gabby Douglas, who was one of the so-called Fierce Five that won gold medals at the London Olympics in 2012, revealed her accusation on Instagram.
The Olympic gymnast wrote: “I didn’t publicly share my experiences as well as many other things because for years we were conditioned to stay silent and some things were extremely painful.”
During the hearing Aly Raisman, a member of the 2012 and 2016 Olympic teams, tweeted that she was “disgusted” that Larry Nassar, who lost his license, was referred to as a doctor.
Larry Nassar’s case was part of a scandal which saw USA Gymnastics president Steve Penny resign in 2016. Steve Penny was accused by victims of failing to quickly notify authorities about abuse allegations.
In a statement after the plea deal was announced, USA Gymnastics – the organization which determines the US Olympic team – said it is “very sorry that any athlete was harmed” by Larry Nassar.
They added that it was “important” that he acknowledged “his appalling and devious conduct” in court and said the deal “permits punishment without further victimization of survivors”.
Larry Nassar has already pleaded guilty to multiple charges of child abusing in federal court and could face a maximum sentence of life in prison.
The former doctor is due to be sentenced on January 12.
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