Objective  To systematically evaluate the effect of exercise on physical function in maintenance hemodialysis (MHD) patients.  Methods   PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM were searched for randomized controlled trials (RCTs) about the effects of exercise on physical function in MHD patients from the inception to January 1, 2022. Meta-analysis was performed by RevMan 5.3.  Results  A total of 25 RCTs with 1478 participants were included. Meta-analysis showed that exercise significantly improved peak oxygen uptake (MD =2.923, 95% CI:1.763～4.083, Z=4.940, P＜0.001), 30s sit-to-stand (STS) (MD=3.005, 95% CI:1.403~4.607, Z=3.680, P＜0.001), 60s STS (MD=2.456, 95% CI:1.140～3.772, Z=3.660, P＜0.001), time up and go (MD=-1.061, 95%  CI:-2.009，-0.114, Z=2.200, P=0.030), and handgrip strength (MD=2.436, 95% CI:0.278～4.595, Z=2.210, P=0.030), but there was no significant improvement in 5 times STS (Z=0.660,P=0.510).  Conclusion  Exercise can improve peak oxygen uptake, 30s STS, 60s STS, time up and go, and handgrip strength in MHD  patients. In practice, we can combine the condition of dialysis centers and MHD patients, actively carry out different exercises, improve the physical function of patients.