Objective Social network analysis (SNA) can measure social connectedness and assess impact of interpersonal connections on health behaviors, including physical activity (PA). This paper aims to systematically review adult PA studies using SNA to understand important social network concepts relative to PA. Data Source A search was performed using PsycINFO, MEDLINE, PubMed, and Web of Science. Study Inclusion and Exclusion Criteria To be included in the search, articles needed to 1) include a measure of PA, 2) conduct an SNA in which specific relationships were measured, and 3) conduct an analysis between social network measures and PA. Data Extraction Key study elements including network design and results were extracted. Data Synthesis Data were synthesized to answer 2 questions: 1) how has adult PA been investigated using SNA approaches and 2) how is an adult’s social network associated with PA behaviors? Results A final sample of 28 articles remained from an initial 11 085 articles. Network size, homophily, network composition, and network exposure to PA were all associated with individual level PA across studies. Lastly, longitudinal and intervention studies showed a more complex picture of social influence and diffusion of PA behavior. Conclusions Adults’ PA behaviors are influenced by their networks. Capitalizing on this influence, researchers should engage not just individual behavior change but also the social influences present within the person’s life.