Physical activity plays a pivotal part in gaining cardio respiratory fitness hence improving academic performance in medical students especially females. Accordingly, it is important to evaluate the effect of physical activity on academic performance of the students using cardio respiratory fitness as a mediator. The study aimed to detect that cardio respiratory fitness goes between physical activity and academic performance in PSAU medical female students. Methods: Assessment of cardio respiratory fitness was done by 20m Shuttle Run Test [SRT], physical activity levels were determined by International Physical Activity Questionnaire [IPAQ] and Academic Performance [AP] was detected by Grade Point Average [GPA] over past three consecutive semesters and the relationship between them was tested. Results: The statistical analysis confirmed a high significant correlation between cardio respiratory capacity, academic performance and physical activity (p<0.05) in moderate and high level physical activity without significant differences in low level physical activity in medical university female students (p > 0.05).The results of the bootstrapped mediation analysis indicated that physical activity had a direct effect on cardio respiratory fitness, which in turn influenced the academic performance among participants only in moderate to high physical activity. Conclusion: Consequently, the hypothesis that cardio respiratory fitness mediates the relationship between physical activity and academic performance in moderate to high activity was confirmed. Physical activity is a prerequisite for improved cardio respiratory capacity, leading to better academic performance for healthy academic life and future career in PSAU medical female students
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