OBJECTIVE: To examine whether cardiorespiratory fitness is associated with health risk factors, independent of abdominal obesity (waist circumference). RESEARCH METHODS AND PROCEDURES: Data from 141 40-year-old Flemish male subjects were used in a cross-sectional design. The main outcome measure in this study was the health risk profile, composed of lipid parameters, blood pressure, and body composition parameters. Data were analyzed by regression analysis and by means of analysis of covariance with waist circumference (WC) as covariate and cardiorespiratory fitness as source of variance. RESULTS: The data demonstrated that cardiorespiratory fitness was significantly associated with triglycerides, with the ratio of total cholesterol/serum high density lipoprotein cholesterol, and with percent body fat, independent of an association with WC. DISCUSSION: Major findings of the present cross-sectional study indicate that a high WC is associated with adverse health-related lipid profile and body composition characteristics and that relatively high levels of aerobic fitness attenuate the health risk associated with a large WC.