Objective: To examine the relationship between abdominal obesity and physical activity in Cree children (5 to 12 years old) living on a reserve in Alberta. METHODS: Anthropometric data were obtained from 105 children. Height and weight were used to calculate body mass index (BMI). Waist circumference and BMI were compared to normative reference data to categorize children's abdominal obesity and weight status, respectively. Pedometers worn for 3 days were used to assess physical activity in a subset of children (n=86). RESULTS: The prevalence of abdominal obesity (49.5%, 52/105), overweight/obesity (56.2%, 59/105) and physical inactivity (64.0%, 55/86) was high. Most overweight/obese children were abdominally obese (83.1%, 49/59). Abdominally obese children took fewer steps per day and were more likely to be physically inactive, although these differences only approached statistical significance. In multiple linear regression, age (beta=3.6 +/- 0.6, p<0.001) and daily step counts (beta=-0.01 +/- 0.00, p=0.009) explained 42.6% of the variance in waist circumference. CONCLUSION: Abdominal obesity coupled with overweight/ obesity and physical inactivity may predispose Cree children to cardiovascular disease and type 2 diabetes. Community-based initiatives that enable healthy lifestyles for children are needed to address excess adiposity.