Natural killer (NK) cells are highly influenced by physical exercise. The possible important mechanisms behind exercise-induced changes in NK cell function are cytokines, hyperthermia, and stress hormones, including catecholamines, growth hormone, cortisol, and beta-endorphins. Infusion studies mimicking stress hormone levels in blood during exercise indicate that increased plasma-adrenaline accounts for at least part of the exercise-induced modulation of NK cell function. During moderate as well as severe acute exercise, the NK cell activity is enhanced, but severe exercise is followed by immunodepression, at least in part caused by prostaglandins. Elite athletes have at rest elevated NK cell activity. However, due to frequent severe exercise the NK cell function is often temporarily severely depressed. It is suggested that during the time of immunodepression microorganisms, especially virus, invade the host, whereby infections can be established. However, in those who perform regular moderate exercise the immune system will often be temporarily enhanced and this will protect these from infections.