Physical activity (PA) implies any force generated by muscle activity at which energy consuption is above those at idle. World Health Organization estimates that 3.2 million of premature deaths per year are caused by physical inactivity. Inadequate levels of PA are global problem due to negative effects on health. The aim of this research was to determine the level of PA and the incidence of painful symptoms of the musculo-skeletal system among final year secondary school students. Additionally, the aim was to determine the association between the level of PA and the incidence of painful symptoms of the musculo-skeletal system. A cross-sectional study on 300 students (51% of females) attending three secondary schools in the area of the city of Vinkovci was conducted using anonymous survey which included basic demographic data of the participants, IPAQ and Nordic Musculoskeletal Questionnaire. The average participants' age was 18,2±0,4 years, and BMI 22,4±3,3 kg/m2. Male participants use bicycles transport to a greater extent (p<0,001). They achieve higher levels of active transport (p=0,044), vigorious intensity PA in the garden (p<0,001), vigorous intensity sports activity (p<0,001), as well as total level of PA (p=0,015). Female participants achieved higher levels of moderate intensity PA in home (p<0,001). Grammar school students achieved the lowest levels of PA. Seventy-seven percent of participants reported some of the painful symptoms of the musculo-skeletal system within the past 12 months, most often in the neck area (43%), more often in females (p<0,001)) and in students of healthcare secondary school (p=0,009). Correlation between the level of total PA, PA in leisure time, sedentary behaviour and symptoms of the musculo-skeletal system have not been found. In conclusion, association between levels of PA, sedentary behaviour and painful symptoms of the musculoskeletal system were not determined.