Background: Stroke is a leading cause of disability, with hemiplegia affecting the motor function of stroke survivors. Traditional rehabilitation methods often yield limited improvements. Virtual reality (VR) technology offers a novel approach to enhancing upper body movements through immersive, task-oriented exercises.Objective: To evaluate the efficacy of VR-based sword fighting exercises in improving upper body movements in hemiplegic patients.Methods: A randomized, controlled, single-blind trial was conducted with 62 hemiplegic patients at Hussain Memorial Hospital, Lahore. Participants were randomly assigned to either the VR-based sword fighting group or the conventional physical therapy (CT) group. Both groups received 12 sessions over three weeks. Outcomes were measured using the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Functional Independence Measure (FIM). Data were analyzed using SPSS version 25, with a p-value of <0.05 considered significant.Results: The VR group showed significantly greater improvements compared to the CT group in post-treatment scores for FIM (115.32 ± 6.665 vs. 79.71 ± 10.681, p = 0.000), FMA, and ARAT (z = -6.778, p = 0.000).Conclusion: VR-based sword fighting exercises significantly improved upper body movements in hemiplegic patients compared to conventional therapy, suggesting a promising role for VR in stroke rehabilitation.