Aims and background: Obesity is linked with diabetes mellitus, hypertension, and cardiovascular problems, as a preventable risk factor, and more prevalent among adults. Physical fitness is the capability to carry out a passive task efficiently and feel physical well-being. It assesses the efficiency of the cardiovascular and muscular systems. Medical students have a greater possibility of becoming obese and it is essential to assess their physical fitness. Hence, this study aimed to correlate physical fitness index (PFI) and blood pressure with obesity markers—body mass index (BMI), waist circumference (WC), and waist–height ratio (WHtR). Materials and methods: 200 1st-year MBBS students were randomly included based on the defined inclusion and exclusion criteria as study subjects. Anthropometric measurements were recorded by following standard procedure, then subjects were allocated to three BMI groups, two WC groups, and two WHtR groups. Parameters noted were: (1) Using a sphygmomanometer and stethoscope blood pressure was recorded and (2) using a modified Harvard step test exercise PFI was calculated. Data analyzed by SPSS, applying Pearson's coefficient of correlation test, a p estimate of below 0.05 was taken as significant. Results: BMI, WC, and WHtR had a negative correlation which was significant with the PFI in the obese group, both males and females, systolic blood pressure was positively correlated with BMI, WC, and WHtR in the obese group. Conclusion: Physical fitness index and blood pressure alter with BMI, WC, and WHtR. These findings create awareness among obese individuals to adopt healthy lifestyles to maintain normal anthropometry. It also helps screen the students at the entry level to the college itself and recommends adopting physical activity to improve their physical fitness.