Older cancer survivors experience the combined deleterious effects associated with aging and a cancer diagnosis. The purpose of the present paper is to review the potential role of physical exercise in attenuating the effects of cancer and its treatments in older cancer survivors. Noting the limited direct research on exercise in older cancer survivors, we review the literature on: (a) older adults in general; and (b) cancer survivors in general. We conclude that although there is limited direct evidence on the benefits of exercise in older cancer survivors, there is compelling evidence of the benefits of exercise in cancer survivors in general and other older populations. We also conclude that exercise adherence will be a significant challenge in this population. Based on this evidence, we tentatively recommend exercise to older cancer survivors using the American College of Sports Medicine's [Med Sci Sports Exerc 30 (6) (1998) 992] guidelines for older adults in general. Finally, we offer future research directions that will provide important evidence needed to guide clinical decisions about exercise in older cancer survivors.