<p>Osteoporosis, a systemic skeletal disorder, is typified by diminished bone mineral density, disruption of bone microstructure, and heightened fracture risk. It has emerged as a critical global public health concern. Traditional drug therapies, while capable of alleviating symptoms, come with inherent limitations. These include protracted treatment cycles, adverse effects, and suboptimal patient compliance. In recent years, exercise intervention has emerged as a safe and cost-effective lifestyle intervention, demonstrating remarkable efficacy in the prevention and management of osteoporosis. The review carefully assesses mechanisms by which endurance exercise, resistance training and whole-body vibration training contribute to the improvement of osteoporosis. Diverse exercise modalities can promote the proliferation and differentiation of osteoblasts while inhibiting the activity of osteoclasts through the synergistic action of multiple targets and signaling pathways. As a result, they can improve bone health and may complement, but not replace, pharmacological treatments, which offers a novel perspective for the prevention and treatment of this condition. Looking ahead, future research should delve deeper into the long-term impacts of exercise intervention and develop personalized exercise programs. Such efforts are crucial for optimizing the treatment strategies for osteoporosis.</p>