Introduction: The efficacy of exercise interventions in the early recovery phase, i.e. started within the first 3 months after hip fracture, has been poorly studied compared to prolonged outpatient interventions. The aim is to examine the effect of early exercise interventions aimed to improve physical function after hip fracture. Methods: We systematically searched MEDLINE via Ovid, The Cochrane Library, Embase, Cinahl, Pedro and AMED (to December 2018). Randomised controlled trials (RCTs) of exercise interventions aimed to improve physical function in the early phase after hip fracture, were eligible. Primary outcome was physical function included: walking ability, walking speed, balance, strength, mobility, and endurance. A meta-analysis was conducted to examine the effect of early exercise interventions and a meta-regression to examine the impact of study characteristics. PEDro appraisal tool was used as a quality assessment in included studies. Results: Nine studies (669 patients) were included. Studies were of high quality with low risk of bias. A statistically significant overall improvement in physical function was found in favor of structured exercise programs (standardised mean difference (SMD) 1.07; 95% CI 0.44-1.70; p<0.001). The meta-regression demonstrated no statistically significant association between study characteristics and structured exercise programs (p>0.05). Conclusion: This is the first systematic review and meta-analysis to summarise the evidence from structured exercise in the early phase after hip fracture. The evidence indicates that structured exercise in the early phase of hip fracture rehabilitation can improve physical function. It remains unclear what type of structured exercise is superior for this population.