Regular physical activity and exercise has long been recognised as a cornerstone of optimal health, playing a crucial role in the prevention and treatment of numerous medical conditions. This article reviews the extensive benefits of exercise, outlines the steps for exercise pre-participation screening based on the latest American College of Sports Medicine (ACSM) guidelines, and emphasiszes the importance of medical clearance. It also discusses the general principles for exercise prescription and the exercise considerations, including the specific precautions for patients with multiple comorbidities, sedentary individuals, the severely overweight, and those with physical disabilities. Additionally, strategies for tailoring exercise advice for patients with low health literacy or motivation are provided. The goal is to integrate fitness into healthcare, particularly in the context of population health initiatives such as Healthier SG. (1). By establishing exercise as a standard component of medical care, we can significantly enhance individual and public health outcomes.