Purpose@#This study aimed to investigate the associations between physical activity (PA), health-related fitness, and metabolic risk factors in Korean gynecological cancer survivors using propensity score matching. @*Methods@#A cross-sectional analysis was performed using national representative data between 2015 and 2018 from the KoreaNational Health and Nutrition Examination Survey (KNHANES VI3 and VI1–3). PA was self-reported through the global PA questionnaire, and health-related fitness was measured using handgrip strength and resting heart rate. Metabolic risk factors were measured by performing blood analyses, including fastingglucose, total cholesterol, and triglyceride levels, and blood pressure. @*Results@#The total number of subjects was 268 (gynecological cancer, n=134; non-cancer, n=134). The results showed that the gynecological cancer survivors (time since diagnosis, <5 years and ≥5 years) participated in less amounts of weekly total moderate-to-vigorous intensity PA (160.0±170.1 vs. 144.6±177.3 vs. 334.1±191.3 min/wk; p<0.001), travel PA (94.5±119.3 vs. 109.4±143.9 vs. 215.7±170.7 min/wk; p<0.001), and walking (190.7±174.5 vs. 258.8±280.8 vs. 444.5±434.7 min/wk; p<0.001) than did the non-cancerpopulation. Moreover, the gynecological cancer survivorswho met the aerobic PA guidelines had significantly lower fastingglucose (p=0.035) and triacylglyceride levels (p=0.013), and systolic blood pressure (p=0.035) than the non-active participants. @*Conclusion@#The PA of the gynecological cancer survivors was lower than that of the general population. Aerobic PA was significantly associated with lower levels of metabolic disturbances in Korean gynecological cancer survivors.