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Objective:This study sought to analyze the prospective association between vigorous-intensity physical activity (VPA) and health-related out-comes in children and adolescents. Methods:Studies reporting associations between device-measured VPA and health-related factors in children and adolescents aged 3-18 years were identified through database searches (MEDLINE, EMBASE, and SPORTDiscus). Correlation coefficients were pooled if outcomes were reported by at least 3 studies, using DerSimonian-Laird random effects models. Results: Data from 23 studies including 13,674 participants were pooled using random effects models. Significant associations were found between VPA at baseline and overall adiposity (r=-0.09, 95％confidence interval (95％CI):-0.15 to-0.03;p=0.002;I2=89.8％), cardiome-tabolic risk score (r=-0.13, 95％CI:-0.24 to-0.02, p=0.020;I2=69.6％), cardiorespiratory fitness (r=0.25, 95％CI:0.15-0.35;p<0.001;I2=57.2％), and total body bone mineral density (r=0.16, 95％CI:0.06 to 0.25;p=0.001;I2=0％). Conclusion:VPA seems to be negatively related to adiposity and cardiometabolic risk score and positively related to cardiorespiratory fitness and total body bone mineral density among children and adolescents at follow-up. Therefore, our findings support the need to strengthen physical activity recommendations regarding VPA due to its health benefits in children and adolescents.