The study investigates the validity of the Physical Activity Scale for the Elderly (PASE) in 21 Dutch elderly men and women. The PASE is an easily scored, brief questionnaire for elderly, suitable for large epidemiologic studies. The PASE score was compared with physical activity measured with the doubly labeled water method. The correlation coefficient of the PASE score with the residuals from the regression analysis using total energy expenditure as dependent and resting metabolic rate as independent variate was 0.58 (95% CI = 0.50-0.81). Women had greater engagement in extremely high scoring activities as housework and taking care of others, resulting in higher PASE scores than men (97.9 and 71.9). The higher scores in women were not linked to higher activity levels, which suggests that the mentioned activities may be overvalued. Sex specific correlation coefficients were 0.79 (CI = 0.32-0.95) and 0.68 (CI = 0.15-0.90) for men and women, respectively. In conclusion, the PASE proved to be a reasonable valid method to classify healthy elderly men and women into categories of physical activity. Some possible refinements were suggested, which may improve the accuracy of the PASE questionnaire.