INTRODUCTION: Ankylosing Spondylitis (AS) is an autoimmune disease characterised by chronic inflammation of the sacroiliac joints and axial spine. The body's immune response to chronic inflammation initiates calcification and excessive bone formation causing structural joint damage and spinal fusion subsequently restricting mobility. AS has a 3:1 male-to-female ratio and symptoms typically appear at 15 - 45 years of age. Current treatment involves both pharmacological and non-pharmacological therapy. PURPOSE: To identify the role of exercise as part of the treatment plan in AS patient. METHODS: Investigate and summarise current knowledge on recommended practice points, frequency, intensity, time and type of exercise as well as progression of an exercise program, in AS patients. RESULTS: Current literature indicates the importance of exercise as part of treatment with pharmacological agents is aimed to delay progression of disease, relieve pain, minimise inflammation, maintain function and improve quality of life. Recommended practice points include a professional team with: knowledge of continual patient assessment and monitoring, realisation of complications, understanding complex exercise and pathology interactions, and a practical approach to the exercise setting that will encourage and motivate patients. The main long-term therapeutic goals should be: posture, mobility and respiratory function. Four key elements of the FITTPro Principle (frequency, intensity, time, type and progression) is recommended in exercise prescription. An AS exercise program of 5 days/week, for 30 minutes/day is advised. It generally consists of daily range of motion (ROM), aerobic-, breathing- and strengthening exercises 1-3 times/week. The type of exercises should fit the patient’s profile e.g. hydrotherapy is beneficial, but contact sports should be avoided. CONCLUSIONS: Individualised continual assessment and exercise prescription with the emphasis on spinal mobility, ROM, muscle strengthening and cardiorespiratory fitness to improve balance, coordination and fitness are an important part of the management plan. Continuous disease modifying treatment including anti-TNFα therapy combined with regular exercise prescription confers additional benefit to pharmacological therapy alone.