We investigated the effects of combined lower body (LB) endurance and upper body (UB) resistance training on endurance, strength, blood lipid profile and body composition in active older men. Ten healthy still active men (73+/-4 years, V(O2) peak: 36 (31-41) ml min-1 kg-1) were tested before and after 14 weeks of combined training (3 times week-1). Training consisted of 3x12 min of high intensity interval training on a bicycle for endurance interspersed by 3x12 min of UB resistance exercises. V(O2) peak during leg cycling and arm cranking, isokinetic torque of knee extensor and shoulder abductor and the cross-sectional area (CSA) of several muscles from UB and LB were measured. Sagittal abdominal diameter (SAD) and abdominal fat area were measured on MRI scans. Total body composition was assessed by hydrostatic weighing (HW) and dual-energy X-ray absorptiometry (DEXA). Blood lipid profile was assessed before and after training. By the end of the training period, V(O2) peak (l min-1) increased significantly by 9 and 16% in leg cycling and arm cranking tests, respectively. Maximal isokinetic torque increased both for the knee extensor and shoulder abductor muscle groups. CSA increased significantly in deltoid muscle. Percentage of body fat decreased by 1.3% (P<0.05) and abdominal fat and SAD decreased by 12 and 6%, respectively (P<0.01). There was also a significant decrease in total cholesterol and low-density lipoprotein. Thus, combined LB endurance and UB resistance training can improve endurance, strength, body composition and blood lipid profile even in healthy active elderly.