Physical activity is an important aspect of health behavior and life-style, when considering the possibilities to prevent premature deaths and sustain functional capacity. We studied former Finnish male athletes and controls to investigate the effects of long-lasting participation in vigorous sports on health, and the main findings are reviewed here. The athletes represented Finland between the years 1920-1965 at least once in international competitions. The following sports were selected: track and field athletics, cross-country skiing, soccer, ice hockey, basketball, boxing, wrestling, weight lifting, and shooting. The full name, place and date of birth were traced for 2613 (97.7%) men. The referent subjects (N = 1712) were selected among those Finnish men who, at the age of 20, were classified completely healthy at the medical examination for induction into military service. In most analyses we grouped the sports according to the type of training needed to achieve maximal results, i.e., principally aerobic training, principally anaerobic training or mixed. In 1985, a questionnaire on physical activity, health and health habits was mailed to surviving former athletes and referents (N = 2851, 65.9% of the original cohort). Follow-up for morbidity and mortality was based on national medical registries. We found that former aerobic sports athletes (endurance and mixed sports) in particular have high total and active life expectancy and low risk for ischemic heart disease and diabetes in later years. On the other hand, they have slightly higher risk for lower-limb osteoarthritis. Overall, the benefits of physically active life-style on health were clearly higher than the adverse effects.