© 2006 Maney Publishing. Rheumatoid arthritis presents many challenges to those involved in its management. Concerns exist over the safety of interventions aimed at increasing aerobic capacity and muscle strength. The objective of this review was to evaluate the outcome of intensive exercise programmes for patients with rheumatoid arthritis on bone mineral density and disease activity. A search of six databases was conducted using relevant search terms. Papers investigating the effect of aerobic and/or strengthening programmes on patients with rheumatoid arthritis were included. Eleven papers out of 30 returned were included; four of these eleven papers had a low risk of bias. Findings from these studies indicated that exercise programmes for patients with rheumatoid arthritis do not increase disease activity, are safe, and slow down the loss of bone mineral in the hip. Results of this review highlight the safety and benefits of aerobic and dynamic strengthening exercise programmes for patients with rheumatoid arthritis.