This study examined the extent to which four essential dimensions of quality physical education teaching (QPET) were associated with healthy levels of physical fitness in elementary school students. Participants were nine elementary PE teachers and 1, 201 fourth- and fifth-grade students who were enrolled in nine elementary schools. The students’ physical fitness were assessed using four FITNESSGRAM tests. The PE teachers’ levels of QPET were assessed using the Assessing Quality Teaching Rubrics (AQTR). The AQTR consisted of four essential dimensions including Task Design, Task Presentation, Class Management, and Instructional Guidance. Codes were confirmed through inter-rater reliability (82.4% and 84.5%). Data were analyzed through descriptive statistics, multiple R-squared regression models, and independent sample t-tests. The four essential teaching dimensions of QPET were significantly associated with the students’ cardiovascular endurance, muscular strength and endurance, and flexibility. However, they accounted for relatively low percentage of the total variance in PACER test, followed by Curl-up test, while explaining very low portions of the total variance in Push-up and Trunk Lift tests. This study indicated that the students who had experienced high level of QPET were more physically fit than their peers who did not have this experience in PACER and Curl-up tests, but not in Push-up and Trunk lift tests. In addition, the significant contribution of the four essential teaching dimensions to physical fitness components was gender-specific. It was concluded that the four teaching dimensions of QPET were significantly associated with students’ health-enhancing physical fitness.