Traditionally anti-fatigue assessment was relied on symptom analysis. Objective assessment of physical capability of anti-fatigue and endurance after tonic herb therapies became crucial to modernization of TCM. CordyMax, a standardized mycelial Paecilomyces hepiali fermentation product of Cordyceps sinensis, is known as a medicinal product for invigoration, health preservation, anti-aging, and anti-fatigue. We examined its anti-fatigue and endurance enhancement properties by use of sports medicine technology in 3 double-blind clinical trials. CordyMax increased VO2max, anaerobic threshold, O2 pulse, and maximal ventilation during exercise, indicating improved aerobic capacity and physical capability of healthy sedentary adults of mid- or advance ages. In young, endurance-conditioned male athletes, it increased VO2max and O2 pulse, reduced heart rate, RER, and blood lactic acid during endurance exercise and reduced fasting blood glucose and resting diastolic BP. It also accelerated cardiovascular recovery after peak exercise. In summary, CordyMax supplementation influences favorably aerobic capacity and cardiovascular, pulmonary, and metabolic functions during endurance exercise, and improves fatigue and endurance performance.