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Objective: To describe physical activity (PA) interventions implemented in American Indian/Alaska Native (AI/AN) populations in the United States and Canada., Data Sources: MEDLINE, PubMed, ERIC, and Sociological Abstracts were used to identify peer-reviewed journal articles. Dissertation abstracts, Web sites, and conference proceedings were searched to identify descriptions within the gray literature from 1986 to 2006., Study Inclusion and Exclusion Criteria: The target population had to be described as AI/ AN, aboriginal, native Hawaiian, and/or native U.S. Samoan. PA interventions among indigenous populations of Latin America were not included., Data Extraction: Descriptions of 64 different AI/AN PA interventions (28 peer-reviewed journal articles and 36 in the gray literature) were identified., Data Synthesis: Data were synthesized by geographic region, intervention strategy, target audience, activities, and sustainability., Results: Most interventions were conducted in the southwest United States (35.4%), in reservation communities (72%), and among participants 18 years and younger (57.8%). Forty-one percent of the 27 interventions with evaluation components reported significant changes in health, behavior, or knowledge., Conclusions: Effective AI/AN PA interventions demonstrated impact on individual health and community resources. Program sustainability was linked to locally trained personnel, local leadership, and stable funding. Culturally acceptable and scientifically sound evaluation methods that can be implemented by local personnel are needed to assess the health and social impact of many long-running AI/AN PA interventions.