Background <p>Post-COVID-19 syndrome (PCS) causes persistent symptoms that impair quality of life, and telerehabilitation (TR) provides an effective remote alternative for addressing these challenges.</p> Aim <p>This study aimed to evaluate the effects of a TR-based exercise program on dyspnea, pain intensity, and functional capacity in individuals with PCS.</p> Design <p>Sixty PCS patients were randomized into a telerehabilitation group (TG, <i>n</i> = 32) or a control group (CG, <i>n</i> = 28). The TG received supervised TR sessions twice a week for 6 weeks, while the CG performed unsupervised home exercises. Assessments were conducted at the baseline and the end of 6 weeks.</p> Results <p>TG showed significantly greater improvements compared to CG. mMRC decreased by 1.16 (95% CI, 0.93–1.38) vs. 0.36 (95% CI, 0.17–0.55), NPRS by 1.44 (95% CI, 0.95–1.92) vs. 0.6 (95% CI, 0.28–0.93), and 5-TST improved by 6.8 s (95% CI, 5.59–8.01) vs. 2.12 s (95% CI, 1.08–3.17). Significant differences were also observed for PSQI (<i>p</i> = 0.018) and HADS-anxiety (<i>p</i> = 0.001).</p> Conclusions <p>A TR-based exercise program significantly reduced dyspnea and pain intensity while improving functional capacity in PCS patients, making it an effective alternative to unsupervised exercise regimens.</p> Trial registration <p>This study is prospectively registered at NCT05381675&#xa0;(<a href="https://www.clinicaltrials.gov">clinicaltrials.gov</a>).</p>