To assess the maximum oxygen uptake (V'O2 max) of Hong Kong Chinese children and to explore its association with respiratory illnesses, we conducted the Multistage Fitness Test (MFT), a 20-m shuttle run test, in 1,427 schoolchildren aged between 8-12 years. Information on respiratory symptoms in the previous year, cumulative respiratory illnesses, and habitual physical activities were collected. Spirometry was carried out to derive forced expiratory volume in 1 sec (FEV1). The V'O2max was 30.3 mL x kg( - 1) x min( - 1) for boys, and 28.6-mL x kg( - 1) x min( - 1) for girls; these values were low by Western standards. V'O2max was significantly reduced in children with asthma ( - 1.3 mL x kg( - 1) x min( - 1)) and bronchitis ( - 0.7.mL x kg( - 1) x min( - 1)) when adjusted for other covariates. A significant decrease in FEV1 was also observed in these children. The correlation between V'O2max and FEV1 was significant but weak. Habitual physical activity was an independent predictor of V'O2max, but not of FEV1. The low V'O2 max in Hong Kong children may be explained in part by ethnic differences and possibly a low level of physical activity.