The purpose of this study was to analyse the relationship between physical activity and physical fitness during adolescence (between 13 and 16 years of age) and cardiovascular disease (CVD) risk factors at adult age (32 years). The following CVD risk factors were considered: lipoprotein levels (total serum cholesterol (TC), high density lipoprotein cholesterol (HDL), the TC:HDL ratio, systolic and diastolic blood pressure, and indicators for body fatness and body fat distribution (sum of four skinfolds, waist to hip ratio, waist circumference). The data were derived from the Amsterdam Growth and Health Longitudinal Study, an observational longitudinal study in which eight repeated measurements were carried out over a period of 20 years. Physical fitness (measured by maximal oxygen uptake per kg bodyweight and by maximal slope reached on a treadmill test) during adolescence was related to a healthy CVD risk profile at the age of 32 years (i. e. inversely to the sum of four skinfolds, waist circumference and to total serum cholesterol). Physical activity during adolescence was not related to a healthy CVD risk profile at the age of 32 years.