Background Cerebral palsy (CP) is a neurological disorder that can affect motor skills and psychophysiological well-being. Virtual Reality Exercise (VRE) has been shown to improve cognitive and physical outcomes for patients with CP. Therefore, the aim of this study was to investigate the effects of VRE on attention, vigor, and decision-making abilities in adolescents with CP. Methods A randomized controlled trial was used. Fourteen Tunisian college adolescents (15.6 ± 0.7 years; diagnosed with CP) were randomly assigned to either the VRE group or the Traditional Exercise (TE) group. The VRE group engaged in 40 min exercise sessions using VRE bike games, while the TE group participated in TE sessions. Results Fourteen participants (42.9 % females) were included in this analysis The results showed that VRE had a significant positive impact on attention and vigor compared to TE. Participants in the VRE group demonstrated improved attention levels and reported higher levels of vigor following the exercise sessions. Conclusions The findings suggest that VRE is an effective intervention for improving attention and vigor abilities in adolescents with CP. Further research is needed to confirm these findings and to investigate the long-term effects of VRE. Registration Pan African Clinical Trial Registry (PACTR202308598603482; 31/08/2023).