In children diagnosed with cancer, both physical and mental health are significantly impacted. Physical activity has emerged as a promising non-pharmacological intervention to improve both physical and psychosocial wellbeing, with growing evidence supporting its role in improving survivorship. Notably, pediatric patients who engage in regular physical activity demonstrate reduced all-cause mortality, particularly among female patients. Current research in physical activity and pediatric oncology aims to further improve mental and physical health, cardiac function, survival outcomes, and overall care. This paper provides an overview of the current state and future directions of the field, emphasizing the need for stronger evidence to support the integration of physical activity as a standard component of care. As the field advances, coordinated efforts among clinicians, researchers, and policy stakeholders will be critical to ensure equitable access to regular physical activity support for all pediatric cancer patients.