Underweight and overweight are serious health concerns for many children and could be associated with low physical-fitness levels. This study aimed (i) to evaluate the prevalence of underweight and overweight and (ii) to examine its association with the physical fitness levels in primary male and female schoolchildren. Including 13 government primary-schools, a cross-sectional survey was conducted between 2014 and 2017. Anthropometric characteristics together with the physical-fitness level

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... measured in 931 schoolchildren aged between 6-and 11-years old. The prevalence of under-and overweight children were 8.49% and 24.06%, respectively. These proportions were not significantly different between males and females and were affected by age (p < 0.001), with a higher prevalence of overweight and a lower prevalence of underweight at 9-11 years, compared to 6-8 years old. Concerning the physical fitness levels, statistical analysis showed a better performance among males compared to females, among participants aged 9-11 years, compared to 6-8 years old, and among underweight and normal-weight, compared to overweight children (p < 0.001). There was a higher prevalence of overweight and lower prevalence of underweight at 9-11 years compared to 6-8 years old. Physical fitness levels were better in (i) males, compared to females, (ii) schoolchildren aged 9-11 years, compared to 6-8 years old, and (iii) underweight and normal-weight, compared to overweight children. The present study showed that underweight and overweight are serious problems for Egyptian schoolchildren, particularly in the 9-11-years old age group. These abnormal weight categories are showed to be associated with a low level of physical fitness. Therefore, physical education teachers, parents, scientists, and coaches should be aware of the higher prevalence of underweight and overweight and its effects on physical fitness levels. Thus, a national multi-domains intervention strategy against abnormal weight is needed to promote physical wellness among Egyptian children. validation, O.A., A.A., and A.H.; formal analysis, A.A. and N.L.B.; investigation, O.A., A.A., and A.H.; resources, O.A.; data curation, A.A.; writing-original draft preparation, O.A. and A.A.; writing-review and editing, K.T., H.C., D.J., K.I., M.T., N.L.B. and A.H.; visualization, N.L.B.; supervision, A.H.; project administration, N.L.B.; funding acquisition, N.L.B. All authors have read and agreed to the published version of the manuscript. All authors have read and agreed to the published version of the manuscript. Funding: This research received no external funding. Conflicts of Interest: The authors declare no conflict of interest.