The Childhood Determinants of Adult Health cohort study has followed 8498 participants in a nationwide survey of Australian school children conducted in 1985. The study builds on extensive childhood measures of health and physical fitness, along with more than four decades of follow-up, to better understand how cardiovascular risk factors develop over time and their health consequences in adulthood. The study has made important contributions to understanding the predictors and long-term impacts of childhood overweight and obesity, low physical fitness, physical inactivity, and smoking. Further seminal contributions have been made through collaboration and data pooling with the International Childhood Cardiovascular Cohort Consortium, demonstrating that traditional cardiovascular risk factors in childhood (body mass index, blood pressure, total cholesterol, triglycerides, and smoking) are associated with cardiovascular disease events in adulthood.