The aim of the research was to identify the effect of 4vs.4 small-sided games (SSGs) with goalkeepers (4vs.4+GK), applied twice a week, for 8 weeks, on U18 football players’ physical ability, compared to that of the athletes who performed specific aerobic endurance training. The research included 40 football players U18, divided into two groups: 20 in the experiment group (EG) aged 17.49 ± 0.61 years and 20 in the control group (CG) aged 17.66 ± 0.54 years. From the initial test (IT) to final tests (FT) performed on the parameters, maximum oxygen consumption (VO2max) and 10 m and 20 m sprint and agility with and without a ball showed a significant increase for both groups. The first and last SSG training was monitored, using total distance (TD), high-intensity distance (HSR—high-speed running) and maximum intensity distance (VHSR—very-high-speed running). Comparative analyses of EG and CG parameters at the FT shows that the differences between the means of two groups are statistically significant in favor of the experimental group in terms of all parameters, except 10 m sprint (p < 0.05). Referring to SSGs, the experimental group had a 7.78% increase rate in TD (p < 0.0005), a 30.90% (p < 0.0005) increase rate with HSR and no significant differences (p > 0.05) with VHSR. The experimental training program of 4vs.4+GK SSGs, applied to U18 football players, produced significant progress in the physical, and functional parameters.