Objective To assess the effect of participating in an exercise intervention compared with no exercise during cancer treatment on the duration and frequency of hospital admissions.

Design Systematic review and meta-analysis.

Data sources MEDLINE, EMBASE, PEDro and Cochrane Central Registry of Randomized Controlled Trials.

Eligibility criteria for selecting studies Randomised studies published until August 2023 evaluating exercise interventions during chemotherapy, radiotherapy or stem cell transplant regimens, compared with usual care, and which assessed hospital admissions (length of stay and/or frequency of admissions).

Study appraisal and synthesis Study quality was assessed using the Cochrane Risk-of-Bias tool and Grading of Recommendations Assessment, Development and Evaluation assessment. Meta-analyses were conducted by pooling the data using random-effects models.

Results Of 3918 screened abstracts, 20 studies met inclusion criteria, including 2635 participants (1383 intervention and 1252 control). Twelve studies were conducted during haematopoietic stem cell transplantation regimens. There was a small effect size in a pooled analysis that found exercise during treatment reduced hospital length of stay by 1.40 days (95% CI: −2.26 to −0.54 days; low-quality evidence) and lowered the rate of hospital admission by 8% (difference in proportions=−0.08, 95% CI: −0.13 to −0.03, low-quality evidence) compared with usual care.

Conclusion Exercise during cancer treatment can decrease hospital length of stay and admissions, although a small effect size and high heterogeneity limits the certainty. While exercise is factored into some multidisciplinary care plans, it could be included as standard practice for patients as cancer care pathways evolve.