Abstract: AIM To investigate the effects of aerobic exercise training on myocardium undergoing ischemia and reperfusion injury (I/RI). METHODS Sixty male healthy Sprague Dawley rats were randomized into three groups: A, sham operation group; B, I/RI group, ischemia 30 min, reperfusion 4 h, and C, I/RI+aerobic exercise training group. Myocardial infarct size, apoptotic index of cardiomyocytes, caspase-3 activity and p-Akt levels were detected. RESULTS Aerobic exercise training reduced myocardial infarct size (n=9, P<0.01), inhibited cardiomyocyte apoptosis (n=10, P<0.01), decreased caspase-3 activity (n=8, P<0.01), and significantly increased p-Akt levels (n=7, P<0.01). CONCLUSION Aerobic exercise training plays a protective role on myocardium undergoing ischemia and reperfusion injury, and its protective effect is partially through PI3K/Akt signal pathway.