Background <p>Geriatric depression is an important issue which comes with the economic burden of billions of dollars annually. It not only reduces quality of life but also affects overall health of geriatric patients suffering from it. Mostly older people do not do regular physical activity due to various reasons and rely on medication to manage depression. Such medicines provide fast response but they also pose severe side effects and the risk of dependency. That is why exercise in best approach to manage depression.</p> Methods <p>It was randomized controlled trial with 32 patients aged ≥ 65 divided into control and experimental group. Control group was only given antidepressants while experimental group received regular strength and aerobic training 3x/week for 8-weeks continuously for 45&#xa0;min. Geriatric depression scale (GDS) was used to measure depression in pre and post intervention.</p> Results <p>Thirty two participants completed the randomized controlled trial (<i>n</i> = 16 per group). The experimental group showed a significant reduction in GDS scores, with decreasing mean scores from 18.63 ± 2.63 at baseline to 15.06 ± 1.83 after the intervention, resulting in a mean change of − 3.56 ± 0.63. In contrast, the control group showed only a minimal change in depression scores, decreasing from 13.06 ± 1.84 to 12.19 ± 1.47, with a mean change of − 0.88 ± 0.34. The improvement observed in the experimental group was statistically significant (<i>p</i> &lt; 0.001) compared with the control group.</p> Conclusion <p>Regular strength and aerobic training are very beneficial in managing depression in elderly patients.</p>