The purpose of this study was to investigate the association between physical activity with fine and gross motor skills in pre-school children with ADHD. The present study is a descriptive-correlational study. The participants were 58 children (20 girls) aged 4 to 6 years who were selected using a convenience sampling method. We utilized Physical Activity Questionnaire for Children (PAQ-C) to measure physical activity. The short form of the Bruininks-Oseretsky Test of Motor Proficiency was used to measure the fine and gross motor. Independent t test and regression analysis were used to analyze the data. Children in this study had low levels of physical activity and motor proficiency. Boys had significantly higher physical activity and motor proficiency than girls (P<0.001). In addition, physical activity was directly and significantly associated with fine and gross motor skills (both P<0.001). These findings indicate that there is a need to increase the level of physical activity in pre-school children with ADHD, especially girls. Moreover, it is recommended that physical education teachers and sports coaches use programs in physical education lessons to facilitate motor skills in children.