The purpose of this study was to report the relationship between fat distribution, physical activity (PA), and cardiovascular disease (CVD) risk factors. Percent fat, computed tomography intra-abdominal adipose tissue (IAF), anthropometrics, Baecke activity questionnaire, and CVD risk (blood pressure, cholesterol, HDL, HDL2, HDL3, IDL, LDL, VLDL, and triglycerides) were evaluated in 137 men 30-71 yr old. IAF was consistently more highly related to CVD risk than other fat distribution variables including percent fat and waist:hip ratio (r = 0.3-0.45). IAF was significantly related to CVD risk after adjusting for other fat distribution variables. With the exception of the sum of biceps, triceps, thigh, and calf skinfolds (peripheral skinfolds), which was negatively related to CVD risk, no other fat distribution variable had consistent significant partial correlations with CVD risk. PA was related to IAF after adjusting for peripheral skinfolds, but PA was not related to peripheral skinfolds after adjusting for IAF, indicating more active men have relatively low IAF. IAF was related to CVD risk after adjusting for PA, but PA was not related to CVD risk after adjusting for IAF. These results indicate that IAF is directly related to CVD risk while the lower CVD risk found with more active men is more directly related to the low IAF found in more active men.