The keenly awaited report after extensive testing found some relatively minor issues, but said Biden was clear of serious physical and neurological problems.
"President Biden remains a healthy, vigorous, 80-year-old male, who is fit to successfully execute the duties of the Presidency, to include those of as Chief Executive, Head of State and Commander in Chief," Biden's physician, Kevin O'Connor, said in a letter published by the White House.
"The President remains fit for duty, and fully executes all of his responsibilities without any exemptions or accommodations."
Biden, the oldest person ever to be US president, spent the morning completing a series of tests that he began last year at Walter Reed National Military Medical Center, a complex in the Washington suburbs with a presidential facility.
He has not declared a reelection bid but is widely expected to do so soon, with the campaign starting to heat up. On the Republican side, so far the frontrunner is former president Donald Trump, whom Biden beat in the tumultuous 2020 election.
Biden is likely to run on his heavyweight political record after two years in which he steered the country past the Covid pandemic, ended the US war in Afghanistan and rallied Western countries opposing Russia's invasion of Ukraine.
However, questions around his age and constant Republican insinuations that he is mentally incompetent will likely be a major through-line during the campaign.
Healthy habits
O'Connor's letter painted a largely glowing picture of a president who benefits from healthy living habits.
"The President does not use any tobacco products, does not drink alcohol, and he continues to work out at least five days a week," the letter said.
Biden measures six feet (1.83 meters) and weighs 178 pounds (nearly 80.7 kg).
The report notes that Biden suffered Covid-19 in 2022 and then a rebound infection, but given he was vaccinated and boosted the symptoms were mild and he "has not experienced any residual symptoms which may be considered 'long Covid.'"
Two issues noted in the previous annual exam, in November 2021, remain mostly unchanged, O'Connor said.
One is the gastroesophageal reflux which causes him to cough often, and the other is a stiff walking motion due to "wear and tear" in his spine.
"The President's gait remains stiff, but has not worsened since last year," O'Connor said.
The doctor reported that "an extremely detailed neurological exam was again reassuring in that there were no findings which would be consistent with any cerebellar or other central neurological disorder, such as stroke, multiple sclerosis, Parkinson's or ascending lateral sclerosis."
Referring to Biden spending "a good deal of time in the sun in his youth," O'Connor wrote that the president has been treated regularly for removal of localized, non-melanoma skin cancers.
"One small lesion on the President's chest was excised today and sent for traditional biopsy," he said.
Does age matter?
While routine, Thursday's physical was closely watched, with Democratic leaders insisting they will stand behind Biden if he runs again, but polls showing little enthusiasm from their voters.
A Reuters/Ipsos poll in February found more than half of Democrats believe Biden is too old to carry on.
Nikki Haley, a 51-year-old Republican who has just entered the 2024 race, called Wednesday for mental fitness tests for any elected official over 75. That would also apply to Trump, 76, under whom she served as UN ambassador.
Asked in interviews about the age factor, Biden points to his achievements in office and says simply: "Watch me."
During Biden's last checkup, he had a colonoscopy under general anesthesia and transferred his powers for one hour and 25 minutes to Vice President Kamala Harris, making her the first woman in U.S. history to serve briefly as acting president.