360 Background: Genetic counseling (GC) and genetic testing (GT) for prostate cancer (PCA) is growing rapidly for men with or at risk for PCA. GC provides opportunities to promote a healthy lifestyle and is understudied in men. To inform future lifestyle interventions, we assessed adherence to physical activity (PA) guidelines among a sample of men undergoing PCA GC/GT at two academic institutions. Methods: Participants enrolled in the Genetic Evaluation of Men study completed a structured lifestyle questionnaire to assess frequency of PA over the past year, including intensity of aerobic activity and strength-based activities. Data were evaluated as M±SD by PCA status, PCA aggressiveness (Gleason>7, T3, or metastatic disease), family history, and body mass index (BMI) with Chi-Square contingency analyses and adjusted residuals. Demographic characteristics predictive of PA adherence with current Department of Health and Human Services and American College of Sports Medicine PA guidelines were assessed using logistic regression analyses. Alpha levels were set a priori to p<.05. Results: Men with (n=158) or at risk (n=96) for PCA who underwent GC/GT were included; 84% were overweight or obese. Men with PCA had less adherence to engaging in moderate (p=.02) and vigorous (p=.01) PA than men without PCA. Men overall who reported engaging in strength-based PA did meet the recommended guideline of 2-3 days per week (p<.01). Lower BMI (p=.05) and higher education (p<.01) were found to be significant predictors for adherence to vigorous PA; older age (p=.02) and higher education (p<.01) were found to be significant predictors for adherence to strength-based PA; and, higher education (p=.02) was found to predict adherence to light and moderate PA (p<.05). Conclusions: High proportions of men undergoing PCA GC/GT were overweight/obese. Furthermore, men with PCA did not adhere to current PA guidelines. Age, BMI, and education were important predictors of PA engagement, which should be considered in intervention development. GC encounters represent “teachable moments” to promote healthy lifestyle among men, which may have additional benefit for survivorship and improved treatment experience.