Little attention has been paid to children with respect to factors controlling maximal oxygen uptake (V.O (2max)). This study was therefore specifically designed to examine the potential relationships between cardiac size, diastolic function and O (2) carrying capacity with maximal aerobic capacity. Specifically, body size indices (body surface area, lean body mass), resting left ventricular dimensions and filling characteristics, blood haemoglobin concentration as well as V.O (2max) established during a maximal cycle exercise test were assessed in a large cohort (n = 142) of healthy 10 - 11 year old boys and girls. Results were compared between groups of low (< 50, L), moderate (50 - 60, M) and high (> 60, H) V.O (2max) (ml . min (-1) . kg (-1) of lean body mass). Moreover, potential contributors to V.O (2max) variance were investigated using univariate and multivariate regression analyses over the overall population. The major results show no differences between the 3 groups for all diastolic and systolic function indices as well as blood haemoglobin and systemic vascular resistances (used as an index of afterload). None of these variables emerged from regression analyses as potential predictors of V.O (2max.) After accounting for body size variation, heart dimensions, and especially left ventricular internal dimensions, differed between H and M and L and were associated with higher cardiac filling and subsequently stroke volume. Strong relationships between V.O (2max) and heart dimensions were noticed, due primarily but not exclusively to the influence of body size. After adjusting for lean body mass, end-diastolic diameter contributed modestly (8 %) but significantly to V.O (2max) variance, which is biologically meaningful.