Knee osteoarthritis (OA) is an increasing problem in the elderly population resulting in pain, functional limitation, disability, reduced quality of life and substantial health care costs.This review of evidence provides recommendations for exercise prescription in those with hip or knee OA.Aerobic, strengthening, aquatic and Taijiquan exercise are beneficial for improving pain and function in people with OA with benefits seen across the range of disease severities.Maximizing adherence is a key element dictating success of exercise therapy.This can be enhanced by the use of supervised exercise sessions (possibly in class format) in the initial exercise period followed by home exercises.Taijiquan reduces pain and improves physical function, self-efficacy, depression and health-related quality of life for knee OA.Exercise plays an important role in managing symptoms in those with hip and knee OA.