Purpose of Review <p>Most youth with type 1 diabetes (T1D) do not meet the guidelines for physical activity engagement, thereby diminishing potential benefits to physical and mental health. This review synthesizes the recent literature on physical activity among youth with T1D and offers recommendations for future research.</p> Recent Findings <p>Studies highlight challenges related to the use of inconsistent measurement tools, which prevent definitive conclusions about the mechanistic factors underlying low physical activity in youth. There has been limited research examining young children and youth newly diagnosed with T1D. Additionally, most interventions to promote physical activity in youth with T1D have involved structured and supervised exercise sessions, leaving a gap in knowledge regarding the potential impact of unstructured and unsupervised exercise interventions. To address these gaps, rigorous studies employing validated measures of physical activity in youth are needed. Interventions should incorporate developmentally appropriate behavioral science theories and emerging technologies in their design. Additional priorities include integrating diabetes technologies into clinical care, more real-world data to improve the accuracy of machine learning models for predicting dysglycemia, and advancing personalized mHealth interventions to promote physical activity in youth.</p> Summary <p>While physical activity is an important area of pediatric diabetes research, gaps remain in our knowledge and intervention development. Physical activity consultations should be a part of routine diabetes care for youth. Research can inform these consultations by providing strategies to promote physical activity uptake and maintenance and by exploring ways to leverage new technologies to help youth with T1D exercise safely.</p>