Background:
Adolescents and young adults are particularly vulnerable to physical inactivity, especially during the transition from secondary school to university. Self-rated health is a validated indicator of physical and mental well-being and is influenced by lifestyle behaviors such as physical activity.

Material and methods:
A cross-sectional study was conducted from March to May 2025 among secondary school and university students in the Czech Republic, Hungary, Poland, and Slovakia. A total of 2,691 university students and 2,085 secondary school students were included in the analysis. Data were collected using a standardized questionnaire based on the International Physical Activity Questionnaire (IPAQ). Associations were analyzed using chi-square tests and Cramer’s V.

Results:
In all the countries, most students did not meet recommended physical activity levels. Among university students, meeting physical activity recommendations was significantly associated with better self-rated health in the Czech Republic, Hungary, and Poland, but not in Slovakia. Among secondary school students, this association was statistically significant in all four countries, with the strongest relationship observed in Poland.

Conclusions:
Regular physical activity is positively associated with better subjective health among secondary school and university students in V4 countries, highlighting the need to promote physical activity within educational systems.