Background and objectivesAfter recovery from COVID-19 associated multisystem inflammatory syndrome in children (MISC), exercise restrictions were advised for 6 months. Studies done to assess exercise capacity at 3–6 months post recovery from MISC, prior to withdrawal of exercise restrictions, yielded varying information. Whether their exercise capacity was on par with their peers at/beyond 1-year post-recovery needed to be assessed. Objectives:Primary: To compare the exercise capacity between children with a history of MISC and unaffected childrenSecondary: To compare the exercise capacity betweena)children with a history of MISC and children with a history of COVID but not MISCb)children with a history of COVID but not MISC and unaffected children. MethodsChildren (aged ≥8 years) who had recovered from MISC >1-year ago (n = 21) were compared with unaffected children (n = 42) and children who had COVID but not MISC (n = 21) respectively using cardiopulmonary exercise testing (CPET). Comparisons were made between 1. Post-MISC vs unaffected 2. Post-MISC vs post-COVID 3. Post-COVID vs unaffected. ResultsCompared with unaffected children, post-MISC and post-COVID groups had similar peak oxygen uptake (VO2 max) but significantly lesser exercise duration. Children who were very sick during their hospitalization for MISC had an exercise capacity comparable to others in the post-MISC group. Overweight/obese children in post-MISC group had a significantly lesser exercise capacity. But the numbers of overweight/obese children and very sick children were not adequate to run a separate sub-group analysis. ConclusionsAt/beyond 1 year post-recovery from MISC, exercise capacity was comparable to healthy children and children who had COVID but not MISC, but exercise duration was significantly lesser. Overweight/obese children need to be followed up longer with emphasis on regular exercises. Children who were very sick during MISC hospitalization had recovered their exercise capacity. Article summaryThis study prospectively compares the exercise capacity of children 1-year after recovery from MIS-C against healthy children and children who suffered COVID but not MIS-C.