Introduction and objectives. To determine whether the level of physical activity or physical fitness (i.e., aerobic capacity and muscle strength) in Spanish adolescents influences lipid and metabolic profiles. Methods. From a total of 2859 Spanish adolescents (age 13.0-18.5 years) taking part in the AVENA (Alimentacion y Valoracion del Estado Nutricional en Adolescentes) study, 460 (248 male, 212 female) were randomly selected for blood analysis. Their level of physical activity was determined by questionnaire. Aerobic capacity was assessed using the Course-Navette test. Muscle strength was evaluated using manual dynamometry, the long jump test, and the flexed arm hang test. A lipid-metabolic cardiovascular risk index was derived from the levels of triglycerides, low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC), and glucose. Results. No relationship was found between the level of physical activity and lipid-metabolic index in either sex. In contrast, there was an inverse relationship between the lipid-metabolic index and aerobic capacity in males (P=.003) after adjustment for physical activity level and muscle strength. In females, a favorable lipid-metabolic index was associated with greater muscle strength (P=.048) after adjustment for aerobic capacity. Conclusions. These results indicate that, in adolescents, physical fitness, and not physical activity, is related to lipid and metabolic cardiovascular risk. Higher aerobic capacity in males and greater muscle strength in females were associated with lower lipid and metabolic risk factors for cardiovascular disease.