"He continues to be fit for duty and fully executes all of his responsibilities without any exemptions or accommodations," White House doctor Kevin O'Connor said in a summary.
"This year's physical identified no new concerns."
Biden, who faces a likely rematch with 77-year-old Donald Trump in November's election, himself joked that the only concern was that doctors "think I look too young."
"Everything's great," he told reporters at the White House.
Biden took a short helicopter ride to the medical center that is often used by US presidents and left after two and a half hours, saluting naval staff and donning sunglasses before leaving in his motorcade.
The only new issue this year was Biden's use of a machine to reduce sleep disruption, along with an emergency dental procedure, O'Connor said after the examination.
- 'Robust' -
Biden continues to suffer a range of minor issues including a stiff walk due to wear and tear in his spine and a minor heart valve issue but there was no significant change in them from last year, the report said.
Crucially, a "reassuring" and "extremely detailed" exam found no sign of neurological problems including Parkinson's or a stroke, it added.
"President Biden is a healthy, active, robust 81-year-old male, who remains fit to successfully execute the duties of the presidency," O'Connor concluded.
Biden's routine medical exam comes as voter concerns mount over the age of a leader who would be 86 at the end of a second term in office.
The issue was thrust further into the spotlight by the special counsel report.
It cleared him of illegally retaining classified documents in his home and garage -- but said he would come across to a jury as a "well-meaning, elderly man with a poor memory."
Biden launched a fiery counterattack in a press conference at the White House, saying his memory was "fine" and slamming the special counsel for claiming he could not remember when his son Beau died of cancer.
"I am well-meaning, and I’m an elderly man, and I know what the hell I'm doing... I put this country back on its feet," he said at the time.
- 'The other guy' -
There has been a growing clamor for Biden to take a cognitive test, but the White House said his doctors had assessed that he did not need one.
"The president passes a cognitive test every day," Press Secretary Karine Jean-Pierre told reporters, citing the domestic and international political issues he dealt with.
"This is a very rigorous job."
This week Biden took a more lighthearted tone while trying to deflect the issue back onto his septuagenarian nemesis Trump.
In an interview with late-night TV comic Seth Meyers on Monday, Biden said he was a better bet than "the other guy," who is only four years younger.
In last year's medical exam Biden got a clean bill of health, although he did have a cancerous skin lesion removed from his chest.
Trump routinely depicts Biden as old, decrepit and unfit for office -- despite being nearly the same age and raising eyebrows with a series of verbal gaffes and memory issues of his own.
The real estate tycoon recently confused his rival Republican Nikki Haley with Democratic former House speaker Nancy Pelosi, and said Viktor Orban was president of Turkey, rather than Hungary.
Haley, 52, has depicted both men as too old for the presidency.
Late last year, Trump released a note from his doctor declaring him to be in "excellent" health, but it was short on details and did not say what tests Trump had undergone when he had a physical in September 2023.
