Levels of leisure-time physical activity and physical fitness are generally higher in the summer than in the winter months for most people living away from the equator. The notion that an abrupt increase in physical activity in the spring, after a period of relative inactivity, can trigger sudden cardiac events has not been confirmed. There are seasonal variations in the physiological responses to exercise and the occurrence of injuries during participation in sports, but it is not known whether these changes are explained by fluctuations in activity levels and environmental conditions, or by any endogenous circannual rhythms in the human. There are indications of endogenous control for some physiological processes (eg, the metabolic responses to a given intensity of exercise) that seem to mediate more favorable effects of exercise on body composition in the winter. Well-trained athletes show obvious seasonality in their competitive performances, generally in line with adopted annual periodization strategies, although these strategies can be disrupted by external seasonal factors, such as heat stress or the susceptibility to upper respiratory tract infections. Maximal oxygen consumption and other physiological indicators of exercise performance might not mirror seasonal variation in real performances, which suggests that top-class athletes maintain a good level of general physical conditioning throughout the year.