The purpose of this article was to provide a comprehensive review of the exercise intervention literature on persons with physical and cognitive disabilities. Electronic searches were conducted to identify research articles published from 1986 to 2006. Of the 80 physical activity/exercise interventions identified in the literature, only 32 were randomized controlled trials. The remaining studies were nonrandomized controlled trials with (n = 16) and without (n = 32) a control group. There was a mixture of exercise training modalities that involved aerobic (26%), strength (25%), and combined aerobic and strength (23%) exercises, but there were no overlapping studies using the same dose of exercise for any of the 11 disability groups. Almost half the studies targeted stroke (20%), multiple sclerosis (15%), and intellectual disability (13%), with significantly fewer studies targeting other disability groups. The current literature on exercise and disability is extremely broad in scope and has limited generalizability to any specific disability group. A new body of evidence is needed with stronger research designs that adhere to precise dosing characteristics for key health outcomes (e.g., pain/fatigue reduction, improved cardiorespiratory health). Multicenter trials will be needed for low-prevalence populations to strengthen research designs and increase generalizability of study findings.