Underweight and overweight in Albania are very big problems of children. In my view as physical education teacher, requesting the field of sports for me is an alarm; these children are growing old. The purpose of this study is to gain a better understanding of the knowledge, attitudes, and behaviors of primary school age children in regards to nutrition and physical activity and the relationship to body mass index. The Sample Participants in this study were chosen by convenience sampling. Among the three school districts who agreed to participate in the study, 132 children and their parents agreed to participate in the study were collected ages 8, 9, and 10-years-old, in three schools in Elbasan, Albania. The SPAN questionnaire is composed of five sections: 1) demographic profile, 2) questions directed at assessing the participant’s nutrition behaviors, 3) questions directed at assessing the participant’s physical activity behaviors, 4) questions directed at assessing the participant’s attitude regarding nutrition, and 5) questions directed at assessing the participant’s nutritional knowledge level. Data Analysis The scored data from the questionnaires were entered into SPSS (Version 13.0) which was used to analyze the data. Cross tabulation was used to compare body mass index with gender, age, and growth chart percentiles. A Pearson’s Correlation Coefficient (with two-tailed probability) was used to examine the bivariate associations between nutrition knowledge, nutrition behavior, physical activity behavior, nutrition attitude and body-mass index. A significant relationship was found to exist between attitude levels and BMI among 8, 9, and 10-year-old children. A positive attitude was shown to be more significantly associated with normal BMI than nutrition knowledge, or nutrition and physical activity behavior. Research indicates that both underweight and overweight in childhood are phenomenon’s that beg for research on prevention and intervention.