Little information is available on the safety of supervised exercise programs for children. This retrospective case review describes the experience over 5 years in a private, outpatient, physician-directed therapeutic exercise program. Observations were made on a total of 47 patients referred by their physicians or parents for exercise programs for diseases, including obesity (26), cystic fibrosis (10), cardiac disease (3), asthma (3), and others (5). Patients performed circuit training with an exposure that consisted of 2,646 total sessions (56.3 ± 63.3 sessions/patient), equivalent to 1,507.9 hours (32.1 ± 35.5 hr/patient) of exercise time. There were three minor accidents (1.9/1,000 patient hours). Physical examination by the attending physician was negative in all three cases: No treatment was indicated, and no patient missed any training time due to these incidents. No significant injuries or cardiorespiratory complications were observed in this exercise program.