<p>This pilot study evaluated the effects of a 12-week combined physical activity and educational drama intervention on core symptoms and physical fitness in children with Autism Spectrum Disorder. Twenty children were randomly assigned to an experimental group (<i>n</i> = 10), receiving the combined intervention, or a control group (<i>n</i> = 10), receiving conventional physical activity. Outcomes were assessed using the Repetitive Behavior Scale-Revised (RBS-R), Social Responsiveness Scale-2 (SRS-2), and a physical fitness test battery. The results indicated that both interventions significantly improved repetitive behaviors and social impairments in children with ASD after 12 weeks (<i>p</i> &lt; 0.001). However, compared to the control group, the experimental group demonstrated significantly greater improvements in the subdomains of stereotyped behaviors (<i>p</i> = 0.004), restricted behaviors (<i>p</i> = 0.008), social communication (<i>p</i> &lt; 0.001), social motivation (<i>p</i> = 0.009), and restricted interests and repetitive behavior (<i>p</i> &lt; 0.001). Both groups improved significantly in physical fitness measures. These preliminary findings suggest that integrating educational drama with physical activity may offer added benefits over physical activity alone in addressing core ASD symptoms, possibly through mechanisms such as embodied learning and dual engagement of social and motor systems. This integrated approach warrants further investigation in larger, adequately powered trials.</p><p><b>Trail registration number</b>: This study has been registered prospectively in the Chinese Clinical Trail Registry(CTR2500103810).</p>