To assess sports participation in young adults with spina bifida and its association with personal, condition-related and psychosocial factors, physical activity and fitness. Fifty-one persons (26 males) participated, mean age 21.1 (standard deviation 4.5) years. We assessed self-reported sports participation, ambulatory status, presence of hydrocephalus, functional independence, social support, perceived competence, exercise enjoyment, self-reported physical activity, peak oxygen uptake and muscle strength. Associations were studied using regression analyses. Thirty-five persons (69%) participated in sports. Sports participation was not associated with condition-related characteristics, but was associated with social support from family, perceived athletic competence and physical appearance (p≤0.05) and tended to be associated with global self-worth. Sports participants had higher self-reported physical activity levels than non-participants (p≤0.05). Furthermore, sports participated tended to be less likely to have subnormal muscle strength (odds ratio = 0.26; p = 0.08) and their peak oxygen uptake was 0.19 l/min higher, but not statistically significant (p = 0.13). In conclusion, sports participation seems to be due to personal preferences rather than physical ability; it could benefit from improving social support and perceived competence, and is associated with higher self-reported physical activity.