This study examined moderate-to-vigorous physical activity (MVPA) trends in physical education (PE) classes and beyond school hours in children's need satisfaction profiles over 3 years. Participants were 445 (girls 256, boys 189) Finnish schoolchildren (M[subscript age] = 11.26 ± 0.32 years). Need satisfaction self-reports and accelerometer-based MVPA data were collected in 17 comprehensive schools over four assessment phases. Four latent profiles based on the need satisfaction trends over time were found: Profiles with Large Decrease, Small Decrease, Small Increase, and Large Increase. The children with the most prominent need satisfaction decreases showed a significant decline in out-of-school MVPA. All the children, irrespective of their need satisfaction profile, exhibited similar patterns of MVPA in PE over the 3-year follow-up. Developing need satisfactions and out-of-school MVPA of the children with the greatest need satisfaction decreases may require enhancements in need-supportive PE activities.