Purpose: To examine the capacity of physiological variables and performance to predict peak oxygen consumption (peak VO[subscript 2]) in children and adolescents living with HIV. Method: Sixty-five children and adolescents living with HIV (30 boys) aged 8-15 years, participated in the study. Peak VO[subscript 2] was measured by breath-by-breath respiratory exchange during an incremental cycle ergometer until volitional exhaustion. Information on the time to exhaustion, maximal power output (Pmax), and peak heart rate (peak HR) were also recorded. Results: Predictive models were developed and all equations showed the ability of performance variables to predict peak VO[subscript 2]. However, Model 1 was based only on Pmax by following equation: Y = 338.8302 + (Pmax [W] * 11.16435), R[superscript 2] = 0.90 and standard error of estimation ("SEE") = 180 ml[dot]min[superscript -1]. Conclusion: The VO[subscript 2] peak can be predicted simply by the Pmax obtained from the incremental cycle ergometer test. This protocol is a valid and useful tool for monitoring the aerobic fitness of children and adolescents living with HIV, especially in resource-limited settings.