People with disabilities report having a wide range of quality of life. Quality of life is typically determined by life satisfaction, and negative and positive affect. Although people with disabilities face many individual, social, and environmental challenges, they often express a good to excellent quality of life. Having a good quality of life, despite these many challenges, is known as the disability paradox. Similarly, the erroneous assumption by many able-bodied people that individuals with disabilities must have terrible lives is also part of the disability paradox. The purpose of this chapter is to examine research showing how exercise can be an important vehicle to enhance quality of life. An overview of quality of life theories, concepts, measurement, and definitions is presented, followed by a review of the research and the mechanisms behind the association between physical activity and quality of life. For instance, feelings of mastery, increased functional fitness, enhanced social support from group and partner exercise, and biological mechanisms are all plausible mechanisms undergirding the salubrious effects of physical activity.