Background: Systematic reviews and meta-analyses have demonstrated that exercise is an effective intervention to prevent falls in older adults living in the community. However, there remains uncertainty about the safety of prescribing exercise in this group, particularly considering many may have underlying osteoporosis. Objectives: To update the review on the effect of exercise on falls by Sherrington et al (2017) and to extract additional data on adverse events and drop outs. Methods: The review by Sherrington was updated to include papers published up to 2017 using the same search techniques and inclusion criteria. Meta-analysis was performed to determine the pooled effect of exercise on fall risk as well as the rates of drop outs and adverse events between trial arms. Results: 94 comparisons from for 81 trials were available for meta-analysis. Exercise reduced the falls rates in community-dwelling participants (pooled rate ratio 0.79, 95% CI 0.74-0.85, p<0.001, I246.3%, 85 comparisons).Where data for adverse events (AEs) were reported in all trial arms, intervention participants reported greater overall AEs than controls (pooled rate ratio 1.08, 95% CI 1.04-1.13, I297.8%, 8 comparisons). Intervention related AEs (IAEs) included falls, muscle stiffness and pain. Fractures were rarely reported as IAEs. Intervention participants were more likely to drop out of before trial completion (pooled rate ratio 1.10 95% CI 1.01-1.19, I245.7%, 83 comparisons). Discussion: Exercise appears to be associated with an increased likelihood of musculoskeletal pain and discomfort in older adults living in the community but there is no increased risk of falls or fractures. In fact, the overall effect of exercise is to reduce the risk of falls. A greater proportion of older adults drop-out from trials when allocated to an exercise arm. This suggests that although exercise is safe and effective, albeit sometimes uncomfortable; more work is required to improve acceptability. Few trials included structured reporting of AE's in all trial arms. Sherrington, et al. Exercise to Prevent Falls in Older Adults: An Updated Systematic Review and Meta-Analysis', Br J Sports Med,51(2017), 1750-58.