Aim <p>To explore the physical activity barriers of older hospitalized patients with chronic diseases and to provide a reference basis for the development of personalized physical activity programs.</p> Design <p>Descriptive qualitative study.</p> Methods <p>Purposive sampling and descriptive qualitative research methods were used to select eighteen medical staff members with different years of experience and eleven older patients with chronic illnesses who were admitted to a tertiary hospital in Hangzhou as study subjects. Semi-structured face-to-face interviews were conducted one-on-one, and the social ecology model and theme analysis method were used to examine the data.</p> Results <p>Four themes and 10 sub-themes were distilled: individual level (health status limitations, negative psychology towards activities, and lack of knowledge about diseases and activities); interpersonal level (lack of diversified social support); organizational level (hospital environmental constraints, limitations of therapeutic factors, lack of equipment and place resources and hospital system limitations); and public policy (insufficient attention to activities in the media policy and insufficient support from healthcare insurance policies).</p> Conclusion <p>According to this study, the most commonly mentioned obstacles to physical exercise among older hospitalized patients with chronic illnesses were symptoms of the disease and a lack of social support. Healthcare providers should concentrate on the psychological aspects of patients’ activities and chronic disease management services, offer them a range of social supports, and develop individualized activity plans for older patients with chronic illnesses who encounter numerous obstacles to physical activity in order to enhance their quality of life.</p>