Background: Fractures are common in children and a frequent cause of emergency department (ED) visits. Fractures can cause long-term complications, such as growth problems. Research on fractures can reveal useful areas of focus for injury prevention. Objective: To assess the role of physical activity in the occurrence of fractures, this study investigates physical activity among children with extremity fractures based on the Global Recommendations on Physical Activity for Health. Methods: A multi-center, cross-sectional study was performed at two EDs in Nijmegen, the Netherlands. Patients between 4 and 18 years of age visiting these EDs with a fracture were asked to complete a validated questionnaire. Results: Of the 188 respondents, 51% were found to adhere to the recommendations. Among participants between 13 and 18 years of age, 43% were adequately physically active, compared to participants between 4 and 12 years of age among whom 56% were adequately physically active ( p = 0.080). Additionally, more males were found to meet the recommendations (60% versus 40%). The most common traumas were sports-related (57%). Sports-related traumas were cited more often among youth between 13 and 18 years of age, compared to those between 4 and 12 ( p < 0.001). Conclusions: A relatively high prevalence of adherence to the Global Recommendations on Physical Activity for Health was observed among children with fractures. Most respondents obtained their fractures during participation in sports. This study emphasizes the need for more injury prevention, especially among youth between 13 and 18 years of age and children participating in sports.