Twelve highly trained male runners ran 15 km at self-selected pace on a treadmill in warm conditions to demonstrate differences in physiological responses, fluid preferences, and performance when ingesting sports drinks or plain water before and during exercise. One hour prior to the start of running, an equal volume (1,000 ml) of either water or a 6% or an 8% carbohydrate-electrolyte (CE) drink was ingested. Blood glucose was significantly higher 30 min following ingestion of 6% and 8% CE compared to water, significantly lower at 60 min postingestion with both sports drinks than with water, but similar after 7.5 km of the run for all beverages. During the first 13.4 km, oxygen uptake and run times were not different between trials; however, the final 1.6-km performance run was faster with both CE drinks compared to water. Despite a lower preexercise blood glucose, CE consumption prior to and during exercise significantly improved performance in the last 1.6 km of a 15-km run compared to water.