Hypertension and cardiovascular diseases are highly prevalent in hemodialysis patients and are associated with the reduction of physical functioning and quality of life. We evaluated the effects of supervised aerobic exercise training on physical functioning, blood pressure, quality of life, and laboratory data in hemodialysis patients. Fourteen patients were evaluated at the beginning and after 12 weeks of stretching exercises (control phase) and at the end of 12 weeks of aerobic exercise training performed during hemodialysis sessions (intervention phase). Patients underwent a 6-min walking test (6MWT), 24-h ambulatory blood pressure monitoring, a Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) quality of life questionnaire, and blood sample collections. After the intervention phase, the 6MWT distance increased from 508.7 +/- 91.9 m to 554.9 +/- 105.8 m (P = 0.001), systolic and diastolic blood pressure decreased respectively from 150.6 +/- 18.4 mm Hg to 143.5 +/- 14.7 mm Hg and from 94.6 +/- 10.5 mm Hg to 91.4 +/- 9.7 mm Hg (P < 0.05), while hemoglobin levels increased from 10.8 +/- 1.2 g/dL to 11.6 +/- 0.8 g/dL (P < 0.05). Moreover, there was a significant increase in the physical functioning, social functioning, and mental health dimensions of the SF-36. Aerobic exercise training during hemodialysis increased physical functioning, reduced blood pressure levels, and improved the control of anemia and quality of life in patients with end-stage renal disease.