The intrinsically adaptive or maladaptive nature of certain activity patterns in fibromyalgia (FM) has been put into question. The role of contextual factors related to their influence on functional limitation is required. Perfectionism complicates the ability to cope of these patients. The aim of the study has been to analyze the moderating role of perfectionism between activity patterns and functional limitation. The sample were 228 women with FM. Moderation analyses were conducted with the PROCESS Macro. Activity avoidance and excessive persistence were associated with poorer functionality, regardless of perfectionism. Pain avoidance and task persistence were more strongly associated with FM impact in women with high or moderate levels of perfectionism. In a clinical setting adapting the recommendations given to patients according to their level of perfectionism would be justified. Pain avoidance might be inadvisable at high levels of perfectionism, and task persistence is recommendable especially when perfectionism is high.