Good physical fitness is associated with favorable serum lipids. Oxidized low-density lipoprotein (ox-LDL) could be even more atherogenic than serum lipids. We studied the association of ox-LDL and serum lipids with physical fitness. Healthy young (mean age 25 years) men (n=846) underwent maximal oxygen uptake (VO2max) and muscle fitness index (MFI) tests and completed a leisure-time physical activity (LTPA) questionnaire. Age (ANCOVA1), age+waist circumference+systolic blood pressure+fasting blood glucose+smoking (ANCOVA3) were used as covariates. The groups with the lowest VO2max, MFI and LTPA had 23%, 16% and 8% higher concentrations of ox-LDL than the groups with the highest VO2max (P<0.0001), MFI (P=0.022) and LTPA (P=0.039) groups, respectively. Subjects with poor fitness (low VO2max or low MFI) or low LTPA had elevated levels of ox-LDL/high-density lipoprotein (HDL)-cholesterol, total cholesterol, LDL-cholesterol, triglycerides and a low level of HDL-cholesterol (ANCOVA1, in all, P<0.05). Furthermore, low VO2max is associated with a high level of ox-LDL/HDL-cholesterol and triglycerides, and with a low level of HDL-cholesterol (ANCOVA3, in all, P<0.05). Also, subjects with low LTPA had a high ratio of ox-LDL/HDL-cholesterol (ANCOVA1, P=0.001). In conclusion, both poor fitness (both low VO2max and low MFI) and low LTPA are associated with a higher concentration of ox-LDL lipids and serum lipids, which may indicate a higher risk for atherosclerosis.