Exercise has been associated with posttraumatic growth in gynecologic cancer survivors (GCS) but the role of extreme/adventure activities has not been investigated. The primary objective of this study was to examine the association between extreme/adventure activities and posttraumatic growth in GCS. A Canadian provincial registry generated a random sample of 2064 GCS stratified by cancer type (i.e., cervical, endometrial, and ovarian) who were mailed a self-report survey that assessed demographic and medical variables, posttraumatic growth, participation and interest in extreme/adventure activities, and exercise growth (i.e., the extent to which the cancer diagnosis itself prompted changes in the amount, type, or nature of exercise activities). Of 621 GCS, only 12.1% reported participating in extreme/adventure activities in the past year. Of 309 GCS interested in a future exercise study, 41.1% were interested in trying extreme/adventure activities. After adjustment for key covariates, neither participation nor interest in extreme/adventure activities were associated with posttraumatic growth. All exercise growth items, however, were significantly associated with all posttraumatic growth scales (all p's < 0.05). In multivariate regression analyses, exercise growth items explained 37.2% of the variance in the posttraumatic growth inventory, 7.2% of the variance in the negative impact of cancer scale, 19.9% of the variance in the positive impact of cancer scale, and 23% of the variance in the benefit finding scale (all p's < 0.001). GCS who change the amount, type, and/or nature of their exercise activities after their diagnosis may be more likely to experience posttraumatic growth.