Problem: Despite calls for physical activity (PA) to be prescribed to individuals with Bipolar Disorder (BD) as a means of improving physical and mental health there has been no systematic review of the potential health risks and benefits of increased PA for individuals with BD. This paper presents the first such review. Method: Systematic searches of six databases were conducted from database inception until January 2009, using a range of search terms to reflect both PA and BD. Studies were subsequently considered eligible if they reported on quantitative studies investigating the effect of PA upon some aspect of physical or mental health in individuals with BD. Results: Of the 484 articles retrieved, six studies met the inclusion criteria. Discussion: Few studies have considered how PA may impact on the physical and mental health of people with BD. Nevertheless existing studies do suggest that physical activity interventions may be feasible and have a role in promoting mental health in this population. We discuss methodological, practical and ethical challenges to research in this area, and outline three research questions that future work should seek to address. Conclusions: Research into the efficacy and safety of PA as an intervention in BD is required to support the development of detailed, population-specific guidelines. © 2009 Elsevier Ltd. All rights reserved.