Purpose <p>Genu varum in older women can impair balance, proprioception, and functional mobility, increasing fall risk. This study aimed to investigate the effect of an eight-week sensorimotor training program on balance, knee proprioception, Hip Abductor Isometric Strength, and functional performance in older women with genu varum.</p> Methods <p>This study was a parallel-group randomized controlled trial. Forty women aged 60–75 years with grade 3 genu varum were randomly assigned to either an experimental group (<i>n</i> = 20) or a control group (<i>n</i> = 20). The experimental group performed a supervised sensorimotor training program three times a week for eight weeks, while the control group maintained their usual daily activities. Outcomes included static balance (Stork test), dynamic balance (Berg Balance Scale), knee joint position sense error (proprioception), hip abductor strength (hand-held dynamometer), and functional performance (Timed Up and Go test). Data were analyzed using ANCOVA, controlling for baseline values.</p> Results <p>After eight weeks, the experimental group showed significant improvements compared to the control group in Stork test (<i>P</i> &lt; 0.001, η² = 0.26), Berg Balance Scale (<i>P</i> &lt; 0.001, η² = 0.84), knee joint position sense (<i>P</i> &lt; 0.001, η² = 0.84), hip abductor strength (<i>P</i> &lt; 0.001, η² = 0.80), and Timed Up and Go test (<i>P</i> &lt; 0.001, η² = 0.92).</p> Conclusion <p>An eight-week sensorimotor training program is an effective intervention for significantly improving balance, proprioception, Hip Abductor Isometric Strength, and Timed Up and Go test in older women with genu varum. These findings support its use in rehabilitation and fall prevention programs.</p> Trial registration <p>Iranian Registry of Clinical Trials IRCT20250306064945N1, 11 April 2025. Retrospectively registered.</p>