This paper reviews the use of exercise programs with obese children and adolescents. Studies included for review met two criteria: 1) children or adolescents were defined as obese using objective criteria for obesity, and 2) obese children or adolescents were provided either different types of exercise programs or an exercise program compared with a no-exercise control condition. Thirteen controlled outcome studies were identified. Experimental design, methods, and outcomes are presented and evaluated for each study. Factors that should be considered in research testing exercise interventions are discussed, including adherence, diet, age, gender, and type of exercise. In addition, the potential for exercise programs in the prevention of obesity in childhood and adolescence is discussed. The results support the continued use of exercise in combination with diet for child and adolescent obesity treatment, but the limited number of controlled studies indicates the need for more research in the area. The potential for exercise programs in the prevention of obesity in childhood and adolescence is discussed.