Background Improving motor skill competency and enhancing health-related physical fitness are desired learning outcomes for school-aged children. Achieving motor skill competency and a healthy level of physical fitness lay a foundation for being a physically active person across a lifetime. The purpose of this study was to investigate relationships between levels of manipulative skill competency and physical fitness for elementary school boys and girls. Methods In this study, 565 fourth-grade students and their 9 physical education teachers were voluntary participants. The students were assessed in 4 basic specialized manipulative skills and 4 fitness components during regular physical education lessons. Data were analyzed with descriptive statistics, univariate analyses, and multiple R 2 liner regression methods. Results Boys were more proficient at the manipulative skills than girls, while girls had significant higher percentages for meeting the healthy fitness zone for the fitness tests than boys. Four manipulative skills significantly predicted progressive aerobic cardiovascular endurance run (PACER), push-up, and trunk lifts tests at p ??0.05 level, but not curl-up test for both boys and girls. Boys and girls in the skill-competent group significantly outperformed their counterparts in the skill-incompetent group on PACER, push-up, and trunk lifts tests at p ??0.05 level, with an exception of curl-up test. Conclusion The more competent in manipulative skills, the higher healthy level in cardiovascular endurance, upper-body muscular strength and endurance, and flexibility the students demonstrated. Demonstrating manipulative skill competence and maintaining a healthy level of physical fitness are 2 major desired learning outcomes for elementary school students to be able to achieve.
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