A systematic review and meta-analysis included 15 randomized controlled trials with 1699 patients with axial spondyloarthritis (axSpA). Exercise interventions significantly improved disease activity as measured by BASDAI (SMD = –0.75, 95% CI: –1.19 to –0.31) and ASDAS (SMD = –0.91, 95% CI: –1.54 to –0.29). They also improved physical function (SMD = –0.26), BASMI spinal mobility (SMD = –0.26, 95% CI: –0.49 to –0.04), chest expansion (SMD = 0.35, 95% CI: 0.04 to 0.65) and reduced fatigue (SMD = –0.53). Subgroup analyzes showed that different modes of exercise and duration of intervention influenced effectiveness. The study supports the inclusion of individualized exercise prescriptions in the standard treatment of axSpA. Registration is under the identifier CRD420251144518.