This study compares the aerobic fitness status of a sample of rural American and Russian children, and examines these findings in light of their out of school physical activity participation. Ten and eleven year old (N = 415) children from both countries completed a 15 m Progressive Aerobic Cardiovascular Endurance Run (PACER) fitness test, and following the test, the children scoring beyond the upper limit of the healthy fitness zone were interviewed with regard to their out-of-school participation in physical activity. The Russian students achieved significantly higher scores than American students (P < .001), and males scored higher than females for both countries (P < .001). After examining the profiles of the students 3 apparent themes begin to emerge: Russian students walk to and from school; the students in both settings who achieve a superior fitness level participate in after school physical activity; after school activities for the American students appear to be more recreational orientated than the Russian students, who participate in structured training in sports clubs. For the students in this study, it appears that participating in after school activity may have contributed to achieving high levels of aerobic fitness.