Objective: To understand the current situation and differences in physical activity among children and adolescents in different regions of China, so as to provide a scientific reference for promoting the level of overall physical activity promotion among children and adolescents in China. Methods: From June to December 2023, the student satisfaction assessment questionnaire for the national children and adolescents theme fitness activity "Run, Youth!" was conducted, which was administered via a combined online and offline questionnaire survey to explore 397 013 students participation in the "Run, Youth!" activity in 2023. Descriptive statistics, Logistic regression, and other approaches were utilized for data analysis. Results: There were notable disparities in the rates of children and adolescents meeting the physical activity standards among northeast China, northwest China, north China, east China, central China and southwest China (10.27%, 11.79%, 9.32%, 8.48%, 8.81%, 7.30%) ( χ 2=33.48, P <0.05). The results of multivariate Logistic regression analysis showed that rate of recommended level of physical activity among children in northwest China, boys, children aged 16-18, children in urban areas were relatively high ( OR =1.12, 1.68, 0.60, 1.88, P < 0.05 ). After adjusting for confounding factors, the results of binary Logistic regression analysis showed that there was an interactive effect relationship between the interaction of region, age, gender, and urban-rural distribution and physical activity among children and adolescents ( OR=0.51, P <0.01). Based on gender analysis, weekly physical activity duration of boys in each region surpassed that of girls; based on age analysis, except for the central and southwestern regions, weekly physical activity duration of children and adolescents gradually increased with age in other regions; based on the proportion of urban and rural areas, weekly physical activity duration of children and adolescents in urban areas across all regions exceeded that in rural areas. Conclusions The attainment rate of sufficient physical activity among children and adolescents in northwest China is the highest, and the differences between regions are not significant. The participation and level of physical activity of male students in each region surpass those of females and the attainment rate of physical activity of physical activity of urban children and adolescents is higher than that of those in rural areas.