This review, published in the Cochrane Database of Systematic Reviews, updates the previous version by Anderson et al. (2011) and assesses the effectiveness and cost-effectiveness of exercise-based cardiac rehabilitation (CR) for patients with coronary heart disease (CHD). The review includes 63 randomized controlled trials (RCTs) involving 14,486 participants, predominantly post-myocardial infarction (MI) and post-revascularization patients. The main findings are: 1. **Mortality**: Exercise-based CR reduced cardiovascular mortality compared to no exercise control (RR 0.74, 95% CI 0.64 to 0.86), but did not significantly reduce total mortality (RR 0.96, 95% CI 0.88 to 1.04). 2. **Hospital Admissions**: There was a significant reduction in the risk of hospital admissions with exercise-based CR (RR 0.82, 95% CI 0.70 to 0.96). 3. **Myocardial Infarctions (MIs)**: There was no significant difference in the risk of MIs between exercise-based CR and usual care (RR 0.90, 95% CI 0.79 to 1.04). 4. **Revascularizations**: There was no significant difference in the risk of revascularizations (coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)) between exercise-based CR and usual care (CABG: RR 0.96, 95% CI 0.80 to 1.16; PCI: RR 0.85, 95% CI 0.70 to 1.04). 5. **Health-Related Quality of Life (HRQL)**: There was evidence of significant improvement in most or all sub-scales with exercise-based CR compared to control at follow-up in five out of 20 trials reporting HRQL using validated measures. 6. **Cost-Effectiveness**: Four trial-based economic evaluations indicated exercise-based CR to be potentially cost-effective in terms of gain in quality-adjusted life years. The quality of evidence for outcomes reported in the review varied widely, ranging from low to moderate. The review concludes that exercise-based CR reduces the risk of cardiovascular mortality but not total mortality, and significantly reduces the risk of hospital admissions. Further well-conducted RCTs are needed to assess the impact of exercise-based CR in higher-risk CHD groups and those with stable angina.This review, published in the Cochrane Database of Systematic Reviews, updates the previous version by Anderson et al. (2011) and assesses the effectiveness and cost-effectiveness of exercise-based cardiac rehabilitation (CR) for patients with coronary heart disease (CHD). The review includes 63 randomized controlled trials (RCTs) involving 14,486 participants, predominantly post-myocardial infarction (MI) and post-revascularization patients. The main findings are: 1. **Mortality**: Exercise-based CR reduced cardiovascular mortality compared to no exercise control (RR 0.74, 95% CI 0.64 to 0.86), but did not significantly reduce total mortality (RR 0.96, 95% CI 0.88 to 1.04). 2. **Hospital Admissions**: There was a significant reduction in the risk of hospital admissions with exercise-based CR (RR 0.82, 95% CI 0.70 to 0.96). 3. **Myocardial Infarctions (MIs)**: There was no significant difference in the risk of MIs between exercise-based CR and usual care (RR 0.90, 95% CI 0.79 to 1.04). 4. **Revascularizations**: There was no significant difference in the risk of revascularizations (coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)) between exercise-based CR and usual care (CABG: RR 0.96, 95% CI 0.80 to 1.16; PCI: RR 0.85, 95% CI 0.70 to 1.04). 5. **Health-Related Quality of Life (HRQL)**: There was evidence of significant improvement in most or all sub-scales with exercise-based CR compared to control at follow-up in five out of 20 trials reporting HRQL using validated measures. 6. **Cost-Effectiveness**: Four trial-based economic evaluations indicated exercise-based CR to be potentially cost-effective in terms of gain in quality-adjusted life years. The quality of evidence for outcomes reported in the review varied widely, ranging from low to moderate. The review concludes that exercise-based CR reduces the risk of cardiovascular mortality but not total mortality, and significantly reduces the risk of hospital admissions. Further well-conducted RCTs are needed to assess the impact of exercise-based CR in higher-risk CHD groups and those with stable angina.