Objective: We evaluated the specific association between physical activity and cognition among older adults with chronic kidney disease in the United States. Methods: Data from the 1999-2002 National Health and Nutrition Examination Survey were used to identify 66 older adults, between 60 and 85 years, with complete data on selected study variables. Diagnosis of chronic kidney disease was assessed through self-report. Participation in physical activity was determined from self-report data. The digit symbol substitution test (DSST) was used to assess participant executive cognitive functioning tasks of pairing and free recall. Individuals were excluded if they had missing data on the study variables assessed, or if they self-reported having coronary artery disease, congestive heart failure, stroke, or a heart attack. Results: Physical activity was associated with higher cognitive performance in this sample. After adjustments, those meeting moderate to vigorous physical activity (MVPA) guidelines (vs. not) had an 8.77 higher DSST score (β = 8.77; 95% CI: 1.65-15.89; P = 0.02). Furthermore, after adjustments, for every 1 metabolic equivalent of task-min-month increase in MVPA, participants had a 0.0007 DSST increase (β = 0.0007; 95% CI: −0.0001-0.001; P = 0.08), although this result was not statistically significant. Conclusion: In this sample of older adults with chronic kidney disease, there was a positive association between physical activity participation and higher levels of cognitive functioning.