abstractObjective: To assess sports participation in young adults with myelomeningocele and its association with personal, disease-related and psychosocial factors, physical activity and fitness. Design: Cross-sectional study. Subjects: Fifty-one persons (26 males) with myelomeningocele, mean age 21.1 (standard deviation 4.5) years. Methods: We assessed self-reported sports participation, ambulatory status, presence of hydrocephalus, functional independence, social support, perceived competence, exercise enjoyment, objective and self-reported physical activity, peak oxygen uptake, muscle strength and body fat. Associations were studied using regression analyses. Results: Thirty-five subjects (69%) participated in sports. Sports participation was not associated with disease-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 (p=0.10). Sports participants had higher self-reported physical activity levels than non-participants (p≤0.05); objective results did not support this. Furthermore, sports participants 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 significantly (p=0.13). 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.text