Objectives <p>Physical activity and meditation may each relate to mental health, but their joint associations in U.S. adults are unclear. We examined the separate and joint associations of any past-year meditation and meeting physical activity (PA) guidelines with depression and anxiety symptoms.</p> Method <p>We analyzed data from the 2022 National Health Interview Survey Sample Adult file (<i>n</i> = 24,927). Exposures were meeting PA guidelines, any past-year meditation, and their four-level combination (Neither, PA only, Meditation only, Both). Outcomes were moderate-to-severe depressive and anxiety symptoms (PHQ-8/GAD-7 ≥ 10). Survey-weighted modified Poisson models estimated prevalence ratios (PRs), with interaction, sensitivity, and post hoc analyses.</p> Results <p>Versus Neither, adjusted PRs for depression were 0.49 (95% CI, 0.42–0.56) for PA only, 1.59 (1.38–1.85) for Meditation only, and 1.27 (1.08–1.50) for Both; corresponding anxiety PRs were 0.69 (0.60–0.80), 1.69 (1.44–1.99), and 1.26 (1.06–1.50). Associations varied by age for both outcomes and by income-to-poverty ratio for depression, but not by sex. In counseling-restricted analyses, the inverse PA-only association remained, whereas Meditation-only and Both estimates attenuated toward the null. Sensitivity analyses were similar.</p> Conclusions <p>Meeting PA guidelines was associated with lower depression and anxiety, whereas reporting any past-year meditation without sufficient PA was associated with higher prevalence, likely reflecting indication/help-seeking. Adults reporting both behaviors had a more favorable symptom profile than Meditation only, but this cross-sectional contrast should not be interpreted causally.</p>