A systematic review analyzed 95 randomized controlled trials from 2015–2024 on the effect of physical exercise on functional fitness in people aged ≥65 years. Most exercise interventions improved functional fitness, with multicomponent programs, resistance training, and controlled protocols being particularly effective. Observed improvements included muscle strength (∼20–40% in the 30-s chair stand test), mobility (∼1.0–2.5 second reduction in the Timed Up and Go test), balance, and walking speed (∼0.08–0.15 m/s). Positive effects were also manifested in body composition, such as increased muscle mass. Effects on cognitive function were inconsistent. Interventions lasting more than 12 weeks with high adherence yielded more favorable outcomes. The heterogeneity of studies precluded meta-analysis.