Increasing age is usually associated with a decline in the amount of habitual exercise activity of an individual in western society. While this reflects a decline in physical capacity, it is in large part due to socio-cultural pressures and expectations. The preservation of any function, intellectual or physical, is dependent upon the use that is made of that function, and the physiotherapist with a unique background in human movement and pathology has a vital role in the prescription and supervision of exercise with the elderly. Exercise has demonstrable effects on skeletal health and bone maintenance, muscle bulk and strength, the ranges of movements of joints, cartilage compliance, soft tissue extensibility, neuronal efficiency and cardiopulmonary fitness. This paper considers some of the physical aspects of ageing on body tissues together with the actual and potential role of physiotherapy in the health education and treatment of elderly people.