Abstract Background Physical inactivity is one of the most important risk factors in modern society. Primary Health Care (PHC) interventions have been shown to be effective to increase physical activity (PA). This work evaluates the Catalan Physical Activity, Sport and Health Plan (PAFES). Methods Nested case–control design with risk-set matching based on a retrospective cohort of 22 450 physically inactive people registered between 2010 and 2018 in the Catalan electronic medical record (EMR). Confounder adjusted conditional logistic regression was used to estimate the probability that participants who had received PA advice became active between 2010 and 2018 compared to those who did not receive it. Results A lower probability to become active [odds ratio (OR) = 0.11, 95% confidence interval (CI) 0.10–0.13] was found for those people who had received PA advice only once. However, the probability to become active increased for people who had received advice two or more times (two times: OR = 1.43, 95% CI 1.32–1.55). A dose–response relationship was observed. Conclusions This is the first study evaluating a PA promotion real-life intervention in PHC using a large cohort based on data from an EMR with more than 2 years of follow-up.