Twelve older inpatients (M age = 66.8) with Major Depressive Disorder (MDD) participated in this controlled pilot trial either in a physical exercise group (PEG; n = 6; aerobic, strength, and coordination exercises) or an active control group (ACG; n = 6; relaxation exercises) twice a week for four weeks. While depressive symptoms decreased in both groups, reduction of symptoms was significantly larger in the PEG. However, the PEG had higher BDI scores compared to the ACG at pretest. Neurocognitive functioning and brain-derived neurotrophic factor (BDNF) concentration did not change significantly. A four-week exercise program may be a feasible adjunct therapy in older MDD patients but the efficacy of the program needs to be proven with larger samples.