A meta-analysis of 24 randomized controlled trials demonstrated that exercise has a positive effect on reducing pain, fatigue and improving quality of life in patients with fibromyalgia. Exercise reduced pain with statistical significance (SMD -0.77), fatigue (SMD -0.39) and improved quality of life (SMD 0.53). Subgroup analyzes showed that aerobic exercise lasting at least 8 weeks, with a duration of 60–90 minutes per session, performed twice weekly without exceeding 180 minutes per week, was most effective. The study recommends this exercise regimen for fibromyalgia patients to achieve maximum pain relief. The research included articles published until July 30, 2025 and was registered in the PROSPERO database. The findings confirm that regular exercise is an effective non-pharmacological approach to treating fibromyalgia.