The aim of this study was to identify the physical factors related to serve speed in male professional wheelchair tennis players (WT). Nine best nationally-ranked Spanish male wheelchair tennis players (38.35 ± 11.28 years, 63.77 ± 7.01 kg.) completed a neuromuscular test battery consisting of: isometric handgrip strength; serve velocity; 5, 10 and 20 m sprint (with and without racket); agility (with and without racket); medicine ball throw (serve, forehand and backhand movements); and an incremental endurance test specific to WT. Significantly higher correlations were observed in serve (r = 0.921), forehand (r = 0.810) and backhand (r = 0.791) medicine ball throws showing a positive correlation with serve velocity. A regression analysis identified a single model with the medicine ball throw serve as the main predictor of serve velocity (r2 = 0.847, p < 0.001). In conclusion, it is recommended that coaches and physical trainers include medicine ball throw workouts in the training programs of WT tennis players due to the transfer benefits to the serve speed.