The purpose of this study was to investigate the combined impact of obesity and physical activity (PA) on the health of older adults. Pedometer-determined steps/d, body-mass index (BMI), resting blood pressure, and fasting glucose (FG) were assessed in 137 older adults (69.0 +/- 8.9 yr). The active group (>4,227 steps/d) had lower systolic blood pressure (SBP; p = .001), diastolic blood pressure (DBP; p = .028), and FG (p < .001) than the inactive group (< or = 4,227 steps/d). The normal-BMI group (18.5-24.9 kg/m2) had lower SBP (p < .001) and DBP (p = .01) than the obese group (> or =30 kg/m2). There were no differences in SBP (p = .963) or DBP (p = 1.0) between active obese and inactive normal-BMI groups. The active obese group, however, had a more favorable FG than the inactive normal-BMI group (chi 2 = 18.9, df = 3, p = .001). Efforts to increase PA of older adults should receive the same priority as reducing obesity to improve BP and FG levels.