Background: A variety of physical interventions have been used to improve reactive balance in older adults. Purpose: To summarize the effectiveness of active treatment approaches to improve reactive postural responses in community-dwelling older adults. Design: Systematic review guided by PRISMA guidelines. Study selection: A literature search included the databases PubMed, OVID, CINAHL, ClinicalTrials.gov, OTseeker, and PEDro up to December 2017. Randomized controlled trials that evaluated quantitative measures of reactive postural responses in healthy adults following participation in an active physical training program were included. Data synthesis: Of 4,481 studies initially identified, 11 randomized controlled trials covering 313 participants were selected for analysis. Study designs were heterogeneous, preventing a quantitative analysis. Nine of the 11 studies reported improvements in reactive postural responses. Conclusions: Several clinically feasible training methods have the potential to improve reactive postural responses in older adults; however, conclusions on the efficacy of treatment methods are limited because of numerous methodological issues and heterogeneity in outcomes and intervention procedures. Keywords: active rehabilitation; balance exercises; perturbation; postural control; reactive balance.