Introduction: Preconception care practices include physical activity, which is identified as an important indicator of behavioural preconception health. A scoping review was conducted to examine the association between physical activity in preconception health and its long-term effects on the later life of the offspring. Methods: The literature was searched in databases CINAHL, ScienceDirect and PubMed, using keywords determined by the study objective. In total, 755 published manuscripts were identified. Two additional manuscripts were identified through manual searching. A total of 17 manuscripts was selected for the final analysis. The data were extracted and summarized using thematic analysis. Results: The selected studies were summarized in two categories: (1) studies associated with physical activity and preconception health behaviour (n = 8), and (2) studies associated with preconception physical activity, fertility, and pregnancy outcomes (n = 9). Conclusions: Despite limited evidence, other indirect scientific evidence shows that physical activity positively affects health, and is therefore strongly recommended during the preconception period. Policymakers, researchers, and healthcare professionals should join efforts in examining the impact of physical activity on preconception health, fertility and birth outcomes, and effectively translate the findings into preconception health guidelines and public policies.