OBJECTIVE: To determine the effectiveness of music interventions in increasing physical activity in older adults. METHODS: Searches until March 2011 were conducted through CINAHL, MEDLINE, EMBASE, PubMED, AMED, PsychINFO, AUSPORT, PEDro, OTseeker, Expanded Academic ASAP, SPORTDiscus, and The Cochrane Library. Selection criteria included older adults, music interventions, physical activity outcomes, and quantitative designs. Two reviewers independently screened records. Study details included objectives, designs, participants, music interventions, physical activity outcomes, and results. Risk of bias was assessed using the PEDro scale. RESULTS: The review included 12 low to moderate quality studies with 309 participants. Three meta-analyses conducted for the review (4 trials and 99 participants) did not demonstrate any within-session differences in comparisons between music and no-music interventions. Two individual trials of moderate quality demonstrated increased capacity to perform physical activity following exercise programs with music over 4 and 8 weeks compared with no-music. There was no evidence that any particular music intervention was superior to another. CONCLUSION: Evidence from a small number of low to moderate quality trials did not demonstrate within-session improvements for older adults who listen to music during exercise. However, there may be cumulative benefits following programs with music over several weeks.