Poor self-perceived health (SPH) is associated with lower levels of physical activity (PA) and the presence of chronic disease in older adults. The purpose of this study was to determine whether SPH is associated with PA levels in older adults with existing chronic disease and whether this differs by disease. Using logistic regressions on data from the Canadian Community Health Survey (N = 33,168) it was found that adjusted logistic regressions revealed that odds of physical inactivity were similar in those with good SPH who reported having respiratory, musculoskeletal, or other chronic disease compared with those with good SPH without these diseases. Those with good SPH who reported having cardiometabolic disease were at significantly greater risk of physical inactivity than those with good SPH without cardiometabolic disease. It is apparent from the current analysis that SPH plays an important role in PA levels of older adults with chronic disease and should be targeted in future interventions.