This paper traces the evolution fitness testing from an athletic emphasis to one with a public health focus and examines the forces that brought about the change in an environment that was not totally receptive. An atmosphere for change was created during this era with the development of exercise physiology, exercise epidemiology, and measurement. The publication of a position paper of physical fitness by exercise scientists and the publication of state health-related fitness tests in the 1970s increased the pressure for change. Contemporary public health research clearly documents the positive role of physical activity, cardiorespiratory fitness, and body composition on health outcomes. During this era, exercise scientists developed valid laboratory and field tests of cardiorespiratory fitness and body composition that have become the standards of practice. Public health researchers have been able to provide valid fitness standards for health promotion. These validate the health-related approach.