The purpose of the study was to evaluate the cross-sectional relationship between BMI and a physical fitness index (PFI) based on four indicators of fitness in a national sample of Taiwanese youth. Height, weight, and four measures of physical fitness (sit-ups completed in 60 s, standing long jump, sit and reach, and 800- or 1600-m run/walk) were measured in a national sample of 102,765 Taiwanese youth 9-18 yr of age: 50,940 girls and 51,825 boys. BMI was calculated for each subject. Within each sex-specific half-year age group, students were classified into five BMI categories based on national percentiles: very low, BMI < 5th percentile; low, BMI >or= 5th but < 15th percentiles; normal, BMI >or= 15th but < 85th percentiles; high, BMI >or= 85th but < 95th percentiles; and very high, BMI >or= 95th percentiles. Z-scores based on sex- and age-specific means and standard deviations were calculated, and the sum of z-scores for the four fitness tests was used as a PFI. Differences in PFI between BMI categories within each sex-specific half-year age group were compared with ANOVA with Bonferroni adjustments. Sex-specific regressions of PFI on BMI, using a nonlinear quadratic model, were done in four broader age categories. Relationships between BMI and PFI are nonlinear and vary with age from late childhood through adolescence. With increasing age during adolescence, the relationship becomes parabolic, and the peaks of the parabola are sharper in adolescent boys than girls. PFI declines in a curvilinear manner with increasing BMI among youth 9-18 yr of age, but the slope of the relationship varies with age.