Objective: To investigate whether participation in a regular exercise programme by patients with ankylosing spondylitis (AS) had a positive impact on their body image. Methods: Semi-structured interview and several questionnaires assessed exercise compliance, mood and other facets of disease impact. Body image was assessed using the Arthritis Body Experience Scale, which measured the concepts of body totality and body self-consciousness. Results: No correlation was found between exercise for AS and body image. However, body totality correlated with acceptance of illness ( „ = 0.37, p < 0.05) and both measures of body image inversely correlated with depression (p < 0.05). Conclusion: Normally, regular exercise has a positive effect on body image, but in AS, from this small study it seems that the recommended exercise program does not influence body image, which in these patients seems more closely related to mood. This warrants further evaluation, as a better understanding of influences on body image might improve compliance with therapeutic regimens.