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The prevalence of opioid use disorder (OUD) has grown exponentially, contributing to a significant increase in overdose deaths, and a public health crisis. Methadone maintenance treatment (MMT) is an effective treatment for OUD; yet, retention in MMT and relapse rates are still high. Physical activity (PA) has been shown to improve treatment retention and relapse rates among those with substance use disorders, however little research has examined PA interventions among those in MMT. Therefore, this dissertation study, guided by the Health Promotion Model, explored PA attitudes (ie, perceived benefits, perceived barriers, self-efficacy, and PA enjoyment), and PA preferences (ie, type, structure, and delivery) of adults with OUD in MMT. A mixed-methods designed was used to examine PA attitudes and preferences, level of PA, and experiences with and perceptions of PA. Adults (N= 100) with OUD accessing …