Introduction: Obesity in adolescents is a significant health concern which is associated with co-morbidities, jeopardizing musculoskeletal health in adulthood.  Other than unhealthy diet, sedentary lifestyle is among the causes contributing to obesity.  Objective: Thus, this study was conducted to examine the association between physical activity (PA) and obesity among adolescents in rural and urban area.  Methods: This cross-sectional study design involved 257 adolescents aged from 13 to 19 years old.  The participants were randomly selected from the secondary schools around Kelantan, Malaysia.  Body weight and heights were measured and Body Mass Index (BMI) was calculated.  The students were asked to complete the International Physical Activity Questionnaire-Short Form (IPAQ-S) to assess the physical activity.  Result: Adolescents in urban area were having significantly higher BMI (p-value <0.001) and lower physical activity (p-value <0.001) than adolescents in rural area. There was also significant association found between BMI and PA among urban and rural area. Conclusion: Adolescents who highly active physically had lower BMI than adolescents who are moderately and not active physically. Having physically active could lower the body weight and BMI, hence increase the musculoskeletal health and reduce the co-morbidity.

Keyword: Adolescents, BMI, Physical Activity, Obesity