Silva, JCG, Domingos-Gomes, JR, Freitas, EDS, Neto, GR, Aniceto, RR, Bemben, MG, Lima-dos-Santos, A, and Cirilo-Sousa, MS. Physiological and perceptual responses to aerobic exercise with and without blood flow restriction. J Strength Cond Res 35(9): 2479–2485, 2021—Although previous studies have demonstrated the potential benefits of aerobic exercise (AE) with blood flow restriction (BFR), these findings have been limited by the approaches used to determine the occlusive pressure. In addition, the physiological and perceptual responses of AE with BFR compared to high-intensity interval exercise (HIIE) remain unclear. Thus, we investigated the physiological and perceptual responses to AE with and without BFR, and HIIE. Twenty-two men were randomly assigned to 4 experimental conditions: AE (40% of maximal oxygen consumption [V˙o2peak]), AE with 50% of BFR (AE-BFR: 40% VV˙o2peak), HIIE (80% V˙o2peak), and a no exercise control condition (CON: 50% of BFR). Each exercise bout lasted 18 minutes, during which oxygen consumption (V˙o2), heart rate (HR), and ratings of perceived exertion (RPE) were measured at rest and at every 3 minutes during exercise. Ratings of discomfort before and after each trial. The HIIE condition induced the greatest increases in V˙o2 and HR (p < 0.05), whereas AE-BFR was significantly (p < 0.05) greater than AE and CON. HIIE and AE-BFR also elicited the greatest (p < 0.05), but similar (p > 0.05), increases in RPE during exercise, although AE-BFR was significantly greater than HIIE immediately after exercise (p < 0.05). AE-BFR and HIIE also induced similar levels of discomfort after exercise (p > 0.05). In conclusion, HIIE induced the greatest increases in V˙o2 and HR, although the perceptual responses were essentially the same compared with AE-BFR. However, albeit inferior to HIIE, V˙o2 was greater during AE-BFR compared with AE, indicating that this training method may be used to replace HIIE and still significantly elevate V˙o2.