Health benefits associated with exercise are only obtained when exercise is maintained. The purpose of this pilot study was to examine the effects of a cognitive behavioral therapy (CBT) intervention on exercise behavior and physical outcomes in older adults. All participants were taught progressive flexibility, strength, and endurance exercises. The control group received no additional treatment. The experimental group was taught to recognize negative thoughts related to exercise and to counter these thoughts with more positive ones. Subsequent exercise behavior and physical outcomes were measured in all participants. Cognitive behavioral therapy was moderately to largely effective in improving the majority of physical outcomes assessed. In addition, CBT was moderately effective in improving several components of self-reported exercise behavior and mildly effective in improving exercise behavior overall. Results suggest that nurses can train older adults to identify and modify thoughts that interfere with or reduce their exercise behavior and thus improve physical functioning.