Stand-up paddle boarding (SUP) is a rapidly growing activity where only anecdotal evidence exists for its proposed health and fitness benefits. The purpose of this study was to profile elite and recreational SUP with respect to anthropometric, physiological and musculoskeletal measurements. A total of 30 SUP participants (15 recreational, 15 elite) and 15 sedentary controls participated in this study. Elite and recreational (rec) SUP participants had significantly lower body fat than sedentary (sed) individuals, elite had significantly higher HDL and significantly lower triglycerides than other groups during lipid profiling (P > 0.05). There were significant differences (P > 0.05) between all groups in maximal oxygen uptake (elite 43.7, s = 5.89 ml · kg–1 · min–1 vs. rec 31.9, s = 7.7 ml · kg–1 · min–1 vs. sed 20.4, s = 3.7 ml · kg–1 · min–1) and anaerobic power outputs (35.7, s = 11.1 W vs. 25.0, s = 11.7 W vs. 13.5, s = 7.1 W). The elite group displayed significantly longer endurance than the recreational and sedentary group in the prone bridge (elite 253.4, s = 67.6 s vs. rec 165.6, s = 42.2 s vs. sed 69.7, s = 31.2 s), right-sided bridge (elite 107.9, s = 34.0 s vs. recreational 68.2, s = 24.1 s vs. sed 34.6, s = 15.5 s), left-sided bridge (elite 99.8, s = 24.9 s vs. rec 68.2, s = 27.2 s vs. sed 32.5, s = 15.2 s) and Biering Sorensen test (elite 148.8, s = 35.4 s vs. rec 127.2, s = 43.2 s vs. sed 71.1, s = 32.9 s). Elite SUP had significantly better static and dynamic postural control when compared to the other groups. This study demonstrates the anthropometric, physiological and musculoskeletal values representative of elite and recreational SUP. SUP appears to be associated with increased levels of aerobic and anaerobic fitness, increased static and dynamic balance and a high level of isometric trunk endurance.