Purpose: Our study purpose was to determine physical activity correlates and barriers among head and neck cancer patients. Materials and methods: Fifty-nine (response rate=91%) head and neck cancer patients from an academic oncology clinic enrolled in a cross-sectional study utilizing chart review and self-administered questionnaire. Results: The majority were men (83%) and white (92%) with mean age of 58±12.8 years and mean months since diagnosis of 18.6±51.9. The strongest bivariate correlates of physical activity included enjoyment (r=0.41; p=0.002), symptom index (r=-0.36; p=0.006), alcohol use (r=0.36; p=0.007), task self-efficacy (r=0.33; p=0.013), perceived barriers (r=-0.27; p=0.047), and comorbidity score (r=-0.27; p=0.042). Stepwise regression demonstrated independent associations with physical activity for enjoyment (β=0.38; p=0.002) and symptom index (β=-0.33; p=0.006; R 2=0.28). The most prevalent barriers significantly associated with physical activity included dry mouth or throat (r=-0.32; p=0.016), fatigue (r=-0.27; p=0.043), drainage in mouth or throat (r=-0.41; p=0.002), difficulty eating (r=-0.32; p=0.015), shortness of breath (r=-0.30; p=0.024), and muscle weakness (r=-0.29; p=0.033). Conclusions: Our results showed that the strongest independent correlates of physical activity were social cognitive (i.e., enjoyment) and treatment-related (i.e., symptom index). Treatment-related activity barriers were frequent and significantly associated with reduced activity. Efforts to enhance exercise adherence in head and neck cancer patients should focus on optimizing enjoyment and managing treatment-related barriers. © 2007 Springer-Verlag.