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Purpose: Physical fitness (PF) is considered an important health marker already in youth with positive influence on adult health. The aim of this study was to investigate the effects of overweight/obesity on most relevant health-related physical fitness (HRPF) components in a group of school-age children. Methods: One hundred and thirteen children (49 male; 64 female; 11-13 years) living in Naples were recruited for the study. Height, weight, waist circumference (WC) and Body Mass Index (BMI) were measured. Physical activity (PA) level and sedentary time were determined by a standard 7-day recall questionnaire. HRPF components were evaluated using EUROFIT-test battery and other validated tests. Results: Overweight/obesity accounted for 32 % in our sample. PA level was significantly higher in boys than in girls and was associated with better performance in several PF tests in boys. Further, boys had a significant higher performance than girls in almost all HRPF evaluated ( p < 0.05) except for sit-and-reach test, independently from PA level. Overweight/obesity specifically impaired performance in bent arm hang and one-half mile run-walk in boys. In addition, boys with higher WC values had poorer performance in 4 × 10 m shuttle run, flamingo balance and standing broad jump tests ( p < 0.05). One-half mile run-walk test resulted significantly associated with higher WC values in a multiple linear regression analysis in boys ( p < 0.05). Conclusions: This study confirms an inverse relationship between overweight/obesity and PF. In particular, high WC values appeared to be strongly associated with poor aerobic performance in boys. Our results also suggest that the ½ mile run-walk test represents a useful test to identify children with a higher cardio-metabolic risk as represented by high abdominal adiposity. [ABSTRACT FROM AUTHOR]