AIM: To provide consensus-based recommendations on safe and effective physical activity and sports participation for children and adolescents with chronic health conditions. METHODS: The Task Force of the European Academy of Pediatrics (EAP) reviewed English-language meta-analyses, systematic reviews, randomised clinical trials and observational studies published between 2000 and 2024 in major databases (Scopus, PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE and EBSCO). Evidence from scientific organisations, including the WHO, was also considered. Recommendations were developed through expert consensus. RESULTS: The position statement provides tailored guidelines for children with juvenile idiopathic arthritis, congenital osteoarticular and musculoskeletal defects, haemophilia, asthma, cystic fibrosis, diabetes, sickle cell trait, hypertension, nephrotic syndrome, inflammatory bowel disease, epilepsy, a history of severe allergic reactions and reduced nephron number. Practical recommendations are summarised for each condition. CONCLUSION: This consensus statement offers a structured, evidence-based framework for healthcare professionals, parents and caregivers to promote safe physical activity and sport participation in pediatric populations with chronic diseases, thereby supporting quality of life and long-term health outcomes.

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