Nassar, who previously received a 40-to-175-year sentence in Ingham County, Michigan, for sexual assault, was sentenced in neighboring Eaton County on Monday on a second set of charges. He is also serving a 60-year federal term for child pornography convictions.
The doctor offered a brief apology to his victims on Monday, saying, "The visions of your testimonies will forever be present in my thoughts."
But Eaton County Circuit Judge Janice Cunningham said Nassar had again suggested in a pre-sentencing interview with authorities that his conduct was legitimate medical treatment.
"I am not convinced that you truly understand that what you did was wrong, and the devastating impact that you have had on the victims, their families and friends," she told Nassar. "Clearly you are in denial. You don't get it."
As Cunningham delivered Nassar's sentence on Monday, Rachael Denhollander, the first woman to make her allegations of abuse public in 2016, smiled broadly and squeezed her husband's hand. After Nassar was led out in handcuffs, a parade of victims lined up to hug and thank Denhollander.
"I'm just ready for it to be over," Bailey Lorencen, who was abused by Nassar as a preteen gymnast, told Reuters. "It's finally done."
Prosecutors have said there are approximately 265 known victims in total, including Olympic gold medalists like McKayla Maroney and Aly Raisman.
The scandal surrounding Nassar has reverberated far beyond the sports world, sparking various investigations into why the US Olympic Committee, sport governing body USA Gymnastics, and Michigan State University, where he also worked, failed to investigate complaints about him going back years.