Public concern has intensified regarding children’s physical inactivity and corresponding low fitness levels. According to national reports, children are not as active as they should be, and their inactivity has negative implications for their health. Regular aerobic exercise in adults influences cardiovascular disease risk factors (CVRF), including high blood pressure (BP) and obesity. However, the influence of regular aerobic exercise on CVRF in children is not fully understood. Significant numbers of children display CVRF, but the relationships between physical fitness assessments used in schools, CVRF for children, and participation in physical activity need to be more closely examined. Therefore, the purpose of this study was to examine the relationships between CVRF indices, such as body composition (BC), resting heart rate, and BP, in 4th and 5th grade children based on their physical fitness scores and self-reported levels of physical activity. Participants were 82 elementary school children (39 boys and 43 girls, M age = 10.57) in a rural southeastern Louisiana community. All participants were screened using a modified PAR-Q for children to exclude anyone with health issues. Parental consent and student assent were obtained. To assess physical fitness, the Fitnessgram Pacer test was used for aerobic endurance and curl-ups and flexed arm hang were indicants of muscular endurance. The Physical Activity Questionnaire for Children (PAQ-C) was administered to assess children’s self-reported levels of physical activity. Resting BP was taken with an aneroid sphygmomanometer. Resting heart rate was also recorded. Skinfolds were assessed using Lange calipers and height and weight with a Health-O-Meter scale to determine percent body fat (BF) and body mass index (BMI) as measures of BC. Data were analyzed using simple correlations. Both measures of BC were negatively related to measures of aerobic and muscular endurance, with percent body fat yielding stronger relationships than BMI. Resting heart rate was also negatively related to aerobic fitness. Blood pressure was not related to any of the fitness measures. Neither CVRFs nor fitness scores were related to self-reported physical activity. Understanding the relationships between fitness tests, CVRFs, and activity is important if we are to use school physical education programs effectively in the effort to improve children’s health. The results of this study suggest that fitness tests are related to CVRFs to some degree, but further study is needed to clarify the relationships between children’s participation in physical activity, CVRFs, and fitness. Keyword(s): assessment, elementary education, physical activity