Abstract Background: In spite of aromatase inhibitors reducing risk of recurrence and mortality, painful side effects often cause women to discontinue use of the drug. Side effects of aromatase inhibitors include joint and muscle pain, loss of bone mineral density, and impairment of heart functioning. Discontinuation of aromatase inhibitors due to these side effects occur in up to 40% of breast cancer survivors, and consequently risks of recurrence and mortality increase. Objective: We developed two interventions designed to reduce inflammation, alleviate pain and stabilize bone mineral density. Methods: We are currently conducting a pilot parallel intervention trial that is targeted toward alleviating side effects from aromatase inhibitors through dietary and exercise controlled interventions lasting for three months. The dietary intervention is an anti-inflammatory Mediterranean diet designed to decrease inflammation and lessen joint and muscle pain. Participants randomized to the Mediterranean dietary intervention are exclusively consuming food provided by Territory Foods®, an outside food preparation and delivery service, local to Los Angeles. Our exercise intervention is designed to mobilize the joints, and strengthen and reduce bone loss. Participants are visiting the UCLA Kinross gym for three days per week and are undergoing tailored exercise sessions delivered from personal trainers following our bone strengthening intervention protocol. Anthropometric measures, muscle strength, DXA scanning of bone mineral density, peripheral arterial tonometry, pulse wave velocity and biomarkers of inflammation, bone turnover and heart functioning are conducted at baseline, mid- and end of intervention. Results: Our trial is targeted to accrue 20 participants. Thus far we enrolled six participants, with three participants completing the trial. Analysis is ongoing and preliminary results will be presented at the San Antonio Breast Cancer Symposium in December, 2022. Post intervention reports from participants have noted a reduction in pain symptoms, moderate weight loss and increase in muscle strength. Citation Format: Catherine L. Carpenter, Aashini K. Master, Olivia Julian, Dina Ben-Nissan, Michele Rakoff, Gail Thames, Zhaoping Li. Improving the health of women on Aromatase Inhibitors: A pilot controlled dietary and exercise intervention trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-06-01.