Pujols reached another milestone in the season when he hit his 300th career double in April 2008. In April and May, he reached base safely (via hit, walk, or hit-by-pitch) for 42 consecutive games. On June 10th, Pujols strained his left-calf muscle and went on the 15-day disabled list for the second time in his career. He was re-activated on June 26, after missing 13 games. Pujols won his seventh career NL Player of the Week award for Aug. 18–24 after batting .579 (11-for-19) with a .652 on-base percentage, a 1.105 slugging percentage, and 10 RBIs. He got his 1,500th career hit on August 30, against the Houston Astros. His 30th home run on September 1, and his 100th RBI on September 11th, made him the first player in MLB history to start his career with eight seasons of at least 30 HR, 100 RBIs, a .300 BA, and 99 runs. He also finished with a league-leading .296 Isolated Power (ISO) average.
On October 13, Pujols elected to have surgery on his troubled right elbow, "a procedure that included decompression and transposition of the ulnar nerve" but not the more invasive Tommy John surgery to relieve persistent pain.
Pujols won a number of awards for the year, including the Players Choice National League Outstanding Player of the Year, and Players Choice Player of the Year (his second Player of the Year Award, having also won in 2003; he joined Alex Rodriguez and Barry Bonds as two-time winners). Pujols was also named The Sporting News Player of the Year for the second time in his career. On October 25, Pujols was named the 2008 winner of the Roberto Clemente Award for the player who best exemplifies the game of baseball, sportsmanship, community involvement, and the individual's contribution to his team.
Pujols won the Fielding Bible Award for defensive excellence at first base for the third consecutive year. For the third time in four years, Pujols was named NL Most Valuable Player in the annual Internet Baseball Awards, a poll conducted by Baseball Prospectus. Pujols also won his fourth Silver Slugger award, having previously won one at 3B in 2001, OF in 2003, and 1B in 2004.
On November 17, Pujols won his second NL MVP Award. The MVP award continues his streak of finishing in the top nine in the BBWAA voting every year of the first 8 years of his career. He ended the year by winning TYIB's 'Hitter of the Year' Award.
The Cardinals had hoped to use the event to show off its planned Ballpark Village residential and entertainment complex to be built on the site of the former Busch Memorial Stadium across the street from the new ballpark. However the plans have not materialized and Cardinals in March said they will use the old park for a softball field and parking lot during the game.
On April 22, 2009, All-Star balloting began on MLB.com with eight position players (excluding pitchers and designated hitters) from each of the 30 teams being nominated for fans to vote. As with last year, only 25 email ballots could be cast and voting officially ended at 11:59 ET on July 2. Final Rosters, with the exception of the final vote, were announced on July 5.
Fans voted for up to three players per league to participate in the State Farm Home Run Derby