This study aims to describe the regional prevalence and patterns of physical activity (PA) and sedentary behavior among Brazilian adolescents. Data from the Brazilian Scholar Health Survey, a nationally representative survey of ninth-grade adolescents [mean age: 14.29 y (14.27–14.29)] conducted in 2015 (n = 101,445), were used. Outcomes were television viewing, sitting time (ST), total PA, and active traveling collected via self-administered questionnaire. Information on frequency of physical education classes and type of school was collected from the school’s director. Frequencies with 95% confidence intervals were used to determine the prevalence and patterns of outcomes. Higher prevalence of PA (≥300 min/wk) and ST (>4 h/d) was found in Midwest (PA = 38.0%; ST = 44.5%), South (PA = 37.6%; ST = 50.1%), and Southeast (PA = 36.1%; ST = 49.3%) compared with Northeast (PA = 29.7%; ST = 36.9%) and North (PA = 34.4%; ST = 34.8%) regions of Brazil. ST was higher among adolescents from private schools (51.5%) than public schools (42.9%), whereas active traveling was greater among students of public schools than private schools (62.0% vs 34.4%). Most inequalities in outcomes between capital and interior cities were in the poorest regions. The results indicate that national plans targeting regional inequalities are needed to improve PA and to reduce sedentary behavior among Brazilian adolescents.