While exercise has emerged as an important contributor to maintaining function and potentially altering disease progression in Parkinson’s disease, Alzheimer’s disease and multiple sclerosis, relatively little is known about its potential to benefit people with Huntington’s disease (HD). Preliminary studies suggest that exercise in people with HD is safe, feasible and may improve quality of life, fitness and motor impairments, although long-term functional changes as well as improvements in cognition have not been demonstrated. Inpatient, multidisciplinary rehabilitation programs have been generally well tolerated and associated with improvement in movement, cognition and mood alongside health-related quality of life; however, most of the published studies have been non-randomised and uncontrolled, and importantly involved extended hospital stays. The aims of this presentation are to: 1) overview the current exercise and physical therapy literature in HD with regards to their short term and long term efficacy, 2) discuss possible mechanisms by which exercise may have a disease-modifying effect in HD, and 3) highlight the need for systematic research to evaluate the optimal mode, intensity and dose of exercise, as well as facilitate adherence and uptake in both premanifest and manifest HD. If shown to be effective, exercise programs have the potential to be used in combination with disease-modifying drugs, cell replacement therapy or genetic manipulations, when available, to maximise the functional benefits of these interventions by facilitating adaptive neuroplasticity. The option of a low cost, widely available, non-pharmacological treatment for people with HD, which either modifies or slows down the rate of progression of HD, will be of immense benefit to people with HD and their families.