A well-known effect of increasing age is the gradual reduction of muscle function, and thus of performance in the activity of daily living. Recent research has shown that, even among the very elderly, exercise can improve not only strength and endurance, but also balance and mobility, thus reducing the risk of falls. The possibility of counteracting some of the age-related muscle changes has also been demonstrated. The article reviews current knowledge of strength and endurance training in the elderly, the importance of exercise to improve physical performance, and how lifelong exercise can counteract the effects associated with the ageing of the neuromuscular system.