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This systematic review provides an overview of research elucidating the relationship between fundamental movement skills (FMS) and physical activity (PA) in children and adolescents.Systematic review.Prospective studies were identified from searches in Cochrane Library, BioMed Central, Education Resources Information Center (ERIC), PubMed, Scirus and SciVerse Science Direct from 2000 through 2013. We screened the titles and abstracts for eligibility, rated the methodological quality of the studies, and extracted data.We identified 23 studies meeting our relevancy criteria. The quality score of the studies ranged from 44% to 89%. Overall relationships between FMS and PA or relationships specific for gender and skill were identified in several studies. The variety of methods for assessing PA and FMS make the comparison of study results difficult. We found strong evidence from cross-sectional studies for a positive relationship between FMS and organized physical activities. Motor skill competency was only of low predictive value for the physical activity level in adults.The results of this review suggest that a cause–effect relationship between FMS and PA is suspected but has not been demonstrated yet. The identification of a causal relationship appears very important to ensure feasibility of practical implementation. This could provide aids for decision making for teachers and coaches, but also for therapists' decision guidance to create training, lessons and therapy adequate to the target group.This systematic review examine the relationship between physical activity and motor skills.The search in six electronic databases identified 23 studies meeting our criteria.The variety of methods make the comparison of study results difficult.Cause–effect relationship between FMS and PA is suspected.