Purpose: The study determined whether the increase in the cross-sectional area (CSA) of psoas major, which is known as a hip-flexion muscle, by resistance training combined with running training improves the performance of long-distance runners. Methods: Subjects were 8 well-trained male long-distance runners. The personal best time in a 5000-m race was 15:10.0 (0:20.5) (mean [SD]). Each subject performed resistance training twice per week with running training for 12 weeks. The authors used 3 resistance training regimens that would train the hip flexor muscles. Training intensity was a maximum of 10 repetitions. The training amount was 3 sets × 10 times during the first 4 weeks followed by 4 sets × 10 times during the last 8 weeks. The authors measured the CSA of psoas major using magnetic resonance imaging and the performance of long-distance runners using a constant velocity running test before (pre) and after (post) the training term. Results: The combination training significantly (P < .01, d = 0.34) increased the CSA of psoas major (pre: 16.2 [1.5] cm², post: 16.7 [1.4] cm²) and significantly (P < .01, d = 1.41) improved the duration of the constant velocity running test (pre: 500 [108] s, post: 715 [186] s). Moreover, multiple regression analysis showed that the pre to post change in the duration of the constant velocity exercise was significantly correlated with the change in CSA of the psoas major. Conclusion: The authors suggest that resistance training of psoas major with running training is correlated with an improvement in the performance of long-distance runners.