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Chronic low back pain diagnosed as lumbar spinal stenosis is a debilitating condition that leads to pain with activity and resultant activity limitation. Lumbar spinal stenosis and the prevalence of other common geriatric comorbidities can complicate exercise testing and prescription in older adults. However, appropriately prescribed exercise that is individually dosed can produce gains in aerobic fitness, muscular strength, mobility, functional task performance, and quality of life. Physical therapists are uniquely qualified to evaluate physical function in individuals with lumbar spinal stenosis and provide individualized exercise prescriptions that can improve functional outcomes, physical activity behaviors, and overall participation in the community.