The objective of this randomised study was to evaluate the influence of exercise-focused group activities on female farmers' physical activity, functional capacity, and work ability over a period of 3 years. Physical activity increased more in the intervention group (n = 62) than in the control group (n = 64) during the first year. By the third year physical activity had almost returned to the pre-intervention level. In the 3-year follow-up examination muscular endurance and cardio-respiratory fitness had improved in the intervention group, and musculoskeletal symptoms had decreased more often in the intervention group than in the control group. The index used to measure perceived work ability showed no changes over the 3-year period. It can be concluded that group activities focused on leisure-time physical activity and work habits can be recommended as health promotion measures for farmers' occupational health services.