OBJECTIVE Aquatic treadmill exercise has traditionally been used for aerobic training during rehabilitation; however, its ability to elicit comparable cardiorespiratory stress compared with land exercise is unclear. The purpose of this study was to investigate the cardiorespiratory (CR) responses elicited during maximal-effort protocols using an aquatic treadmill (ATM) and a land treadmill (TM). METHODS Twenty-three college runners participated in two continuous, incremental peak oxygen consumption protocols (ATM and TM) until volitional exhaustion. For the ATM protocol, subjects were submerged in 28 degrees C water to the xiphoid process. ATM speed was increased incrementally to 206.8+/-23.1 m.min, and water jet resistance was increased 10% every minute thereafter. For the TM protocol, speed was increased to 205.3+/-22.3 m.min, and grade was increased 2% every minute thereafter. Rest between sessions was at least 48 h. Oxygen consumption (VO2), heart rate (HR), minute ventilation (VE), tidal volume (VT), breathing frequency (f), and respiratory exchange ratio (RER) were measured continuously, with peak values used for analysis. Rating of perceived exertion (RPE) was recorded immediately after each test, and blood lactate (LA) was measured 3 min afterward. RESULTS VE and f were significantly greater in ATM versus TM; however, VO2, HR, VT, RER, LA, RPE, speed, and exercise times were similar for both protocols. CONCLUSIONS Despite differences in VE and f, it seems that the fluid resistance created by water and jets in an ATM elicits peak CR responses comparable with those seen with inclined TM. These findings suggest that ATM running may be as effective as TM running for aerobic conditioning in fit individuals.