To research the possible role of Tai Chi in preventing cardiovascular disease and improving cardiopulmonary function in adults with obesity aged 50 years and older.Between 2007 and 2012, 120 adults with obesity, aged 50 years and older, were divided into a Tai Chi group and a control group, with 60 participants in each group. The 2 groups were evaluated for weight, waist circumference, hip circumference, blood pressure (BP), body mass index, and incidence of chronic disease during follow-up monitoring.Two- and 6-year follow-up showed that the average BP in the Tai Chi group along with either the systolic or diastolic pressure decreased significantly compared to those in the control group (P < .001). Waist and hip circumference, weight, and body mass index in the Tai Chi group were significantly reduced compared to those in the control group (P < .001). The cardiopulmonary function of the control group and the Tai Chi group changed, with the cardiac index significantly higher in the Tai Chi group than in the control group (P < .05). The Tai Chi group had significantly higher levels of lung function, including vital capacity, maximal oxygen uptake, and total expiratory time, than the control group. The total incidence of complications and mortality in the Tai Chi group were much lower than those in the control group (P < .001). The incidence of cardiovascular and cerebrovascular disease in the Tai Chi group (16.67%) was lower than that in the control group (38.33%).Tai Chi is not only a suitable exercise for elderly people with obesity, but it can also help to regulate BP, improve heart and lung function in these individuals, as well as reduce the incidence of cardiovascular disease and other chronic diseases, helping to improve their quality of life.