The Maya ball game (MBG) originated more than 3,000 years ago. As best as is now known from archaeological and iconographical sources as well as the structure of the sport courts, this was a very physically taxing and important part of Mayan culture. The objective of this paper was to determine the physical load on those who participated in MBG as best as could be done from present perspectives. The load appears to be similar to that observed in soccer-tennis, in which heart rate rises to 140–160 beats/min and systolic blood pressure to 150–170 mm Hg. This is considered a light-to-moderate workload (4.5–5.5 metabolic equivalents) comparable to intensities reached in baseball, cycling (10 km/h), cross-country skiing (7 km/h), tournament dancing, swimming (2 km/h), doubles tennis and hiking (7 km/h). Thus, the cardiovascular demands of popular sports seem to have remained relatively similar through several millennia.