The impact of physical fitness, sleep and blood pressure on the lifestyle habits of high school students has shown relevant aspects. The objective was to analyze the level of physical fitness, sleep quality and blood pressure in high school students in São João dos Patos/Maranhão. This is a cross-sectional study with a quantitative approach, applied to 115 high school students from public schools, with an average age of 16 years. Data was collected at school, during the morning shift, between September and November 2023. The following were measured: blood pressure (professional arm pressure monitor, model HBP-1100/ONROM-USA), physical fitness (Brazil Sports Program protocol) and sleep quality (Pittsburgh Sleep Quality Index). After the Kolmogorov-Smirnov normality test, the data was analyzed using appropriate descriptive measures and compared using statistical tests such as unpaired t, Mann-Whitney U and Fisher's Exact Test. The significance level adopted was 5%. The data was analyzed using GraphPad Prism 8.0 and Jamovi 2.3.28 software. The blood pressure levels of the majority of female (67%) and male (49%) students were adequate. There were significant percentages for the healthy zone in flexibility (female: 65%, male: 69%). In abdominal strength, there were significant levels in the risk zone (female: 100%, male: 98%). The majority of students (female: 98, male: 75%) are in the healthy zone risk factors for cardiorespiratory resistance. The majority of students (female: 73%, male: 38%) had poor sleep quality. Thus, the study highlighted gender differences in measurements and concerns about hypertension. In addition, issues with cardiorespiratory endurance and sleep were observed, pointing to the need for healthy interventions. Despite the limitations, the findings are important for health and education professionals in preventing health problems at this crucial stage of development.