Healthy, active ageing is an important public health goal, which is supported by appropriate, specific, targeted physical activity. Many physiological changes to the cardiovascular and musculoskeletal system may lead to a decline in strength, fitness and resilience as the human body ages. Exercise is a proven means of overcoming physiological functional limitations and maintaining independence throughout the lifespan. The World Health Organisation, American College of Sports Medicine and American Academy of Family Medicine have proposed guidelines for the minimum amount of physical activity to be performed each week by older adults. Each adult needs an individualized mix of aerobic, strength-training, balance and flexibility exercises, to maintain autonomy, reduce chronic disease risk and enjoy a good quality of life. This review summarizes the important highlights of these recommendations and focusses on the significant physiological gains to be achieved from exercise.