Traumatic brain injury (TBI) can result in a range of physical, cognitive, emotional and behavioural problems. Exercise is increasingly advocated in brain injury rehabilitation since individuals with long-term conditions are at particular risk of deconditioning and secondary disease or impairment as a result of inactivity. Maintaining an active lifestyle can help brain injured individuals to regain confidence and independence, and further, exercise has been associated with reductions in physical and cognitive impairments, fatigue and depression, which often accompany TBI. This chapter identifies some key arguments for promoting exercise in TBI, and provides an overview of the research evidence evaluating exercise intervention in this population identifies some major limitations of existing work in this field and provides suggestions for further investigation. A case study is presented which shows the introduction of an alternative form of exercise intervention into the community day centre setting.