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This study evaluated the cardiorespiratory capacity of persons with MR with and without Down syndrome. Analyses of individual data records of maximal exercise tests with metabolic analyses were conducted on tests of 111 subjects(31 men and 16 women with DS; 35 men and 29 women without DS) from six participating centers. All centers used a walking treadmill protocol previously shown to produce valid and reliable maximal tests with this population. Peak oxygen uptake and peak minute ventilation were higher in men than in women (P < 0.006), and in subjects without DS(P < 0.006). Peak heart rate was also higher in subjects without DS (P < 0.006). Peak respiratory exchange ratio (RER) was higher in subjects without DS (P < 0.006). Using peak RER as a covariate did not change the results. An analysis of peak minute ventilation, heart rate and ˙VO2 of subjects with a peak RER above 1.1 revealed the same results. These data show that individuals with mental retardation have low levels of peak ˙VO2, consistent with low levels of cardiovascular fitness. Individuals with Down syndrome have even lower levels of peak˙VO2 than their peers without Down syndrome, a finding that is possibly mitigated by the lower peak heart rates of the individuals with Down syndrome.