Fostering childhood physical activity and fitness levels could have important implications for public health, given growing concerns about high obesity rates, the amount of time spent being sedentary and not getting enough physical activity already at early childhood. World Health Organization states that from 1975 to 2016, the prevalence of children and adolescents with overweight or obesity increased more than four-fold from 4% to 18% globally. Obesity prevention is critical in controlling obesity-related noncommunicable diseases, psychological, and social problems, as well as inferior academic achievement mediated by others attitude and diminished executive cognitive function. A decline of physical activity from early childhood into middle childhood and further to adolescence has been reported. Accompanying health risks from low activity and high sedentariness are comparable to those arising from obesity, and the impact extends into adulthood. Wide range of physical, mental, and cognitive health benefits related to high physical fitness levels in children have been reported. This chapter aims to summarize current evidence clarifying whether higher physical activity is associated with higher physical fitness, and whether higher physical fitness predicts healthier body composition and better cognitive functions in children.