Participation in physical activity has important beneficial effects on physical and psychological health. Many outcomes associated with physical activity are typically compromised in survivors of childhood cancer. The purpose of this study was to describe self-perceptions of physical activity in survivors of acute lymphoblastic leukemia (ALL) and to explore the relationships of these findings with quality of life measures and clinical descriptors. 62 children and adolescents treated previously for ALL and 71 comparable healthy subjects completed the Children’s Self-perceptions of Adequacy in and Predilection for Physical Activity (CSAPPA) scale and the Health Utilities Index (HUI). The ALL subjects had significantly poorer self-perceptions of their adequacy in and predilection for physical activity than the comparison group. Stepwise regression analyses identified high risk for relapse, female gender, and older age, but not body-mass-index, age, age at diagnosis, length of time off therapy, or cranial irradiation as significant predictors of CSAPPA total scores in the ALL group. HUI overall scores and single attribute scores for emotion, cognition and pain had significant positive correlations with various CSAPPA scores. Results suggest that survivors of ALL are less inclined to participate in physical activity and physical activity scores are related to quality of life scores. Long-term follow-up should include education and programming to promote participation in physical activity.