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Background: Physical activity and fitness level of fitness decline mostly between adolescence and early adulthood. This leads to risks of non-communicable diseases in the future. Medical students, assumed to have an extensive understanding of physical exercise and its benefits, are less active than they were before attending graduate school. This study aimed to assess changes in physical fitness and physical activity of students over-time. Methods: This was a prospective study undertaken at Basic Science Complex of Kathmandu Medical College Teaching Hospital in Nepal. In total, 72 medical students were put through a modified Harvard step test during their first year and then three years later during their third year at medical school. Maximum aerobic capacity (VO 2 max) was calculated subsequently by plotting the average pulse rate on the Astrand-Rhyming Nomogram. Results: The mean value of relative maximum aerobic capacity (VO 2 max) decreased from first year to the third year. When the mean values of body mass index and relative maximum aerobic capacity were compared between first year and third year, the difference was found to be statistically significant (p-value=0.000). The physical fitness index and relative maximum aerobic capacity in both years were positively correlated r (70) = +.59, p<0.001(first year); r (70) = +.47, p<0.001(third year). Meanwhile, body mass index and relative maximum aerobic capacity in the third year were negatively correlated and statistically significant with r (70) = -0.23, p=.045. Conclusions: Cardiorespiratory fitness of the students steadily declined as they progressed through their academic years. Positive correlation between cardiorespiratory fitness and physical fitness index was established along with negative correlation between body mass index and cardiorespiratory fitness. The findings in this study expose the lack of fitness in youth as they focus more on academics, giving the impression that they forget to implement a fitness routine in their lifestyle.