A sedentary lifestyle is an important risk factor leading to cardiovascular disease. Cardiovascular disease is particularly frequent in kidney transplant recipients, with a mortality rate of 38%. In this population, besides the classic risk factors (genetics, age, smoking, etc.) and disease-related factors (chronic renal failure, dialysis vintage) there are the side effects of immunosuppressive therapy such as diabetes and metabolic syndrome. Despite the general advice given on an appropriate lifestyle, most transplanted patients lead a sedentary life which may result in overweight. In this study the physiopathological effects of a sedentary lifestyle were analyzed with reference to the recent literature regarding the efficacy of physical activity in transplanted patients. Studies in the general population have demonstrated the beneficial effect of physical activity on the prevention of cardiovascular disease. There are only few studies within the kidney transplant population regarding regular physical activity and these studies were performed with heterogeneous protocols and different observation periods, and are therefore difficult to compare. Overall, positive results in terms of maximal aerobic capacity, muscle strength and perception of well-being have been obtained in the short and medium term (1 year). Further studies are necessary to verify the effect of physical activity on long-term patient and graft survival. In order to enhance physical activity in transplanted patients, local programs in collaboration with sports rehabilitation centers are to be recommended.