The aim of the present review is to clarify the relationship among physical activity, aging and age-related cardiovascular disease, particularly referring to the possible preventive role of a correct physical activity. Analyzing the litterature data, there is a big body of evidence that physical activity is able to improve several meabolic and haemodinamic parameters also in elderly population such as it is widely demonstrated the modulating action of physical training on sympathetic nervous system. Several possible mechanisms are involved in the positive action of physical activity on cardiovascular system: a) increase in collateral vessels of coronary arteries; b) positive influence on coagulation, fibrinolysis and platelet adesivity; c) antiatherogenic changes of lipidic pattern; d) reduction of cardiac sensivity to cathecolamines and strenghthening of baroreceptorial mechanism and vagal modulation; e) neuro-endocrine changes at different levels including the reduction of insulin-resistance. The experimental and physiopathological data have been confirmed by the results of the main clinical-epidemiological studies that widely show the preventive efficacy of physical activity on the cardiovascular risk factors, including diabetes, and demonstrate the independent role of physical activity in the prevention of cardiovascular diseases at high prevalence in the elderly population. For these reasons a correct physical activity, also in aged, should be practised and followed as such as a pharmacological teatment.