BackgroundMajor Depressive Disorder (MDD) causes global disability and economic burden. Standard treatments often yield incomplete recovery with impaired health-related quality of life (HR-QoL). This meta-analysis evaluates exercise interventions’ effects on HR-QoL in adults with clinically diagnosed MDD.MethodsFollowing PRISMA 2020 guidelines, randomized controlled trials (RCTs) of adults (≥18 years) with MDD were included if they evaluated physical activity/exercise interventions (e.g., aerobi