Objective: To systematically evaluate the effect of exercise intervention on the improvement of bone mineral density in middle-aged and elderly women. Methods: PubMed, Science Direct and other databases were searched, and Revman5.3 software was used to evaluate the methodological quality of the included studies. Results: BMD was significantly improved in middle-aged and elderly women after exercise intervention (SMD=0.65, 95%CI: 0.29-1.02). Through subgroup analysis, it was found that aerobic exercise or resistance exercise, intervention period ≥12 months, intervention intensity of medium to high intensity, exercise 3 times a week, exercise ≥30min each time had the best effect on improving bone mineral density in middle-aged and elderly women. Conclusion: Exercise intervention can significantly improve bone mineral density in middle-aged and elderly women, which is an effective means to prevent osteoporosis. It is recommended that the elderly follow the recommended exercise program, which is more conducive to delaying bone loss.