BACKGROUND: Survival rates among cancer survivors have improved; however, treatments affect body esteem. Body esteem can significantly affect quality of life and depression following cancer treatment. The purpose of these secondary analyses was to examine the relationship between changes in fitness and body fat with changes in body esteem among colorectal cancer survivors who participated in a randomized controlled trial that tested the effects of a 12-week physical activity intervention. METHOD: Male and female colorectal cancer survivors (< 5 years since diagnosis) participated in a randomized controlled trial that tested a 12-week moderate-intensity physical activity intervention. Body esteem, fitness (estimated VO peak), and body composition (bioelectrical impedance) were assessed at baseline and follow-up visits (3 months, 6 months, and 12 months). RESULTS: Forty-six colorectal cancer survivors (57 years old, 57% female) completed the study. Improvements in fitness were associated with improvements in body esteem among males at 6-month and 12-month follow-up visits, while improvements in body fat were associated with increased body esteem at 12-month follow-up among females. Improvements in fitness and body fat among stage 0-2 survivors were associated with significant improvements in body esteem, with no significant changes among stage 3 survivors. CONCLUSION: Results from this study showed that improved fitness and body composition can improve body esteem among these survivors; however, differences exist among gender and disease stage. TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT00230646?term=Pinto&cond=Colorectal+Cancer&rank=2.