Objective This meta-analysis included papers which evaluated the effects of physical activity on the health-related quality of life (HRQoL) of osteoporotic and osteopenic postmenopausal women. Methods Four English databases were searched for relevant randomized clinical trials (RTCs) published from 1970 to June, 2014. Eligible RCTs which used the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) as their outcome measure were selected for inclusion. Results Five RCTs were included in the final meta-analysis. The results showed that physical activity produced favorable effects in the HRQoL domains of physical function (p = 0.001) and pain (p = 0.01), but not in other domains. Compared with a single exercise, combined exercise produced more favorable effects on both physical function (p = 0.0004) and pain (p = 0.02). Short-term physical activity produced significant favorable results in all general health domains of HRQoL (p = 0.01), whereas middle-term physical activity produced significant improvements only in the physical function (p < 0.01) domains of HRQoL. Long-term physical activity produced significant improvement only in the pain domains of HRQoL (p < 0.01), and only in the physical activity group when compared with a control group. Conclusion Only weak evidence supports the notion that physical activity effectively improves the health-related quality of life of osteoporotic and osteopenic postmenopausal women. Compared with a single exercise, combined exercise produced favorable effects on both physical function and pain. However, different lengths of exercise produced improvements in different domains.