The objective of this study was to examine the long-term effects of exercise on physiological function, functional capacity, and quality of life (QOL) and health status in patients with heart failure. PubMed and CENTRAL were searched (March 2001 to March 2011) for randomized controlled trials for the keyword "exercise heart failure." Data were abstracted by a single author (B.D.R.) and reviewed by another author (R.A.). Fifteen studies were included. Results were mixed between studies for most measures of physiological function, functional capacity, and QOL and health status. In conclusion, compared with usual care, exercise increased a number of measures of functional capacity and QOL in patients with heart failure. Most of the measures of physiological function were not reported across multiple studies; therefore, no trend could be identified for these measures.