This review evaluates the effectiveness of exercise interventions in preventing falls among older adults living in the community. The study included 108 randomized controlled trials (RCTs) involving 23,407 participants across 25 countries. The primary outcome was the rate of falls, with secondary outcomes including the number of fallers, fractures, hospital admissions, medical attention, health-related quality of life, and adverse events. Exercise interventions, including balance and functional training, resistance training, Tai Chi, and other forms of exercise, were compared to control interventions. The results showed that exercise reduced the rate of falls by 23% (rate ratio 0.77, 95% CI 0.71 to 0.83) and the number of fallers by 15% (risk ratio 0.85, 95% CI 0.81 to 0.89). Balance and functional exercises reduced falls by 24% (rate ratio 0.76, 95% CI 0.70 to 0.81) and the number of fallers by 13% (risk ratio 0.87, 95% CI 0.82 to 0.91). Multiple types of exercise, including balance and functional exercises plus resistance exercises, reduced falls by 34% (rate ratio 0.66, 95% CI 0.50 to 0.88) and the number of fallers by 22% (risk ratio 0.78, 95% CI 0.64 to 0.96). Tai Chi reduced falls by 19% (rate ratio 0.81, 95% CI 0.67 to 0.99) and the number of fallers by 20% (risk ratio 0.80, 95% CI 0.70 to 0.91). Exercise may reduce the number of people experiencing fall-related fractures by 27% (risk ratio 0.73, 95% CI 0.56 to 0.95) and the number of people experiencing falls requiring medical attention by 39% (risk ratio 0.61, 95% CI 0.47 to 0.79). However, the effect on falls requiring hospital admission was unclear. Exercise had little effect on health-related quality of life, with a standardized mean difference of -0.03 (95% CI -0.10 to 0.04). Adverse events were reported in 27 trials, but were mostly non-serious. The review concludes that exercise programs reduce the rate of falls and the number of people experiencing falls in older adults living in theThis review evaluates the effectiveness of exercise interventions in preventing falls among older adults living in the community. The study included 108 randomized controlled trials (RCTs) involving 23,407 participants across 25 countries. The primary outcome was the rate of falls, with secondary outcomes including the number of fallers, fractures, hospital admissions, medical attention, health-related quality of life, and adverse events. Exercise interventions, including balance and functional training, resistance training, Tai Chi, and other forms of exercise, were compared to control interventions. The results showed that exercise reduced the rate of falls by 23% (rate ratio 0.77, 95% CI 0.71 to 0.83) and the number of fallers by 15% (risk ratio 0.85, 95% CI 0.81 to 0.89). Balance and functional exercises reduced falls by 24% (rate ratio 0.76, 95% CI 0.70 to 0.81) and the number of fallers by 13% (risk ratio 0.87, 95% CI 0.82 to 0.91). Multiple types of exercise, including balance and functional exercises plus resistance exercises, reduced falls by 34% (rate ratio 0.66, 95% CI 0.50 to 0.88) and the number of fallers by 22% (risk ratio 0.78, 95% CI 0.64 to 0.96). Tai Chi reduced falls by 19% (rate ratio 0.81, 95% CI 0.67 to 0.99) and the number of fallers by 20% (risk ratio 0.80, 95% CI 0.70 to 0.91). Exercise may reduce the number of people experiencing fall-related fractures by 27% (risk ratio 0.73, 95% CI 0.56 to 0.95) and the number of people experiencing falls requiring medical attention by 39% (risk ratio 0.61, 95% CI 0.47 to 0.79). However, the effect on falls requiring hospital admission was unclear. Exercise had little effect on health-related quality of life, with a standardized mean difference of -0.03 (95% CI -0.10 to 0.04). Adverse events were reported in 27 trials, but were mostly non-serious. The review concludes that exercise programs reduce the rate of falls and the number of people experiencing falls in older adults living in the