Objective: To investigate the effects of a sustainable physical activity promotion program developed for older women with osteoarthritis. Design: A non-equivalent control group pretest–posttest designMethods: This study included 51 elderly women with osteoarthritis who received treatment as the outpatients of general and orthopedic specialty hospitals that were located in the city of J were included. Participants were assigned to an experimental group (26) or a control group (25). An exercise program developed for this study was performed three times per week over 12 weeks for 60-90 minutes per day ober 12 weeks. The sustainable exercise program combined exercise and education. Data were collected from pre-program and post-program assessments. Pre assessment, participants' general characteristics, physical fitness (flexibility of the left and right shoulders, muscle strength of the lower and upper part of the body and static and dynamic balance) and exercise self-efficacy were assessed. Data were analyzed using chi-square test, Fisher's exact test, independent t-test, and repeated measures analysis of variance with SPSS for Windows (version 27.0). Results: The post program assessment showed that, there were statistically significant differences between the experimental and the control groups in right shoulder flexibility (F＝50.672, p＜0.001), left shoulder flexibility (F＝11.321, p＜0.001), upper limb strength (F＝10.844, p＜0.001), lower limb strength (F＝92.672, p＜0.001), dynamic balance (F＝89.501, p＜0.001), static balance (F＝16.964, p＜0.001), and exercise self-efficacy (F＝124.122, p＜0.001). Conclusions: The sustainable physical activity promotion program was found to be effectively in improbed physical fitness and exercsie self-efficacy in older women with osteoarthritis. Thus, an adaptation promotion program for older women with osteoarthritis, is proposed.