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Therapeutic physical exercise programs reduce certain comorbidities and complications in patients with chronic diseases. Therapeutic physical exercise programs (also known as adapted physical activity, APA) have been shown to decrease hypertension and reduce mortality in patients with type 2 diabetes. Diabetes and obesity are frequently associated with the development of non-alcoholic fatty liver disease (NAFLD). These can progress to liver fibrosis and ultimately to metabolic cirrhosis (NASH cirrhosis). Our systematic review of the literature found an improvement in the aerobic capacity and quality of life of cirrhotic patients who undertook a therapeutic physical exercise program. Physical exercise could reduce the intrahepatic venous pressure gradient without causing any side effects. It could reduce the length of stay in hospital of liver transplant patients and could combat the recurrence or de novo appearance of NAFLD after transplantation.