African Americans (AAs) have a higher risk for cardiovascular disease (CVD) compared to their Caucasian American (CA) counterparts, which represents a major health disparity. Low cardiorespiratory fitness (CRF) is a well-established independent risk factor for all-cause and CVD mortality, which has been shown across many epidemiological and clinical trials to be lower in AAs compared to CAs. While much attention has been given to traditional health disparity risk factors (e.g. blood pressure, obesity, insulin resistance), the impact of racial differences in CRF on CVD mortality has not been widely considered. Thus, the purpose of this paper is to review the literature on: 1) the magnitude of racial differences in CRF and the potential clinical significance, 2) examine the relationships between CRF and mortality in AAs and CAs, 3) Potential physiological and behavioral etiologies for racial difference in CRF, and 4) the impact of exercise training on CRF and other cardiometabolic risk factors in AAs compared to CAs. Given that both CRF and change in CRF are associated with reduced CVD mortality, advocating aerobic exercise training or moderate to vigorous activities in AAs has the potential to reduce racial cardiovascular health disparities.