Aerobic fitness depends upon the components of oxygen delivery and the oxidative mechanisms of the exercising muscle. Peak oxygen uptake is recognised as the best single criterion of aerobic fitness but it is strongly correlated with body size. Methods of controlling for body size are discussed and it is demonstrated how inappropriate use of ratio scaling has clouded our understanding of aerobic fitness during growth and maturation and across time. Changes in aerobic fitness over time are reviewed but no published study of peak oxygen uptake, appropriately adjusted for body mass and maturation, has investigated secular changes in aerobic fitness. Data expressed in direct ratio with body mass provide limited insights into secular changes in aerobic fitness but aerobic performance appears to be decreasing in accord with the secular increase in body mass. Cross-sectional and longitudinal peak oxygen uptake data are analysed in relation to age, maturation and sex. Muscle lactate production and blood lactate accumulation are outlined and young people's blood lactate responses to submaximal and maximal exercise are examined. However, exercise of the intensity and duration required to monitor conventional laboratory measures of aerobic fitness are rarely experienced in young people's lives. In many situations it is the oxygen uptake kinetics of the non-steady state which best assess the integrated responses of the oxygen delivery system and the metabolic requirements of the exercising muscle. The chapter therefore concludes with a discussion of insights into aerobic fitness provided by the emerging database on young people's oxygen uptake kinetics responses to exercise of different intensities.