[Purpose] This study examined the effect of a Swiss ball exercise program for elderly females on physical fitness and balance ability in order to offer basic data for the development of an exercise program to improve the quality of life and promote the health of elderly females. [Subjects] Sixty-five elderly women aged over 78 participated in this study. [Methods] The subjects were divided into two groups: an exercise group and a control group. The exercise group (n=38) performed a Swiss ball exercise program which consisted of 12 types of exercises required for balance and performance of functions twice a week for 12 weeks. Physical fitness (Sit-to-Stand, Arm Curl, Sit-and-Reach, Back Scratch) and balance ability (One-Legged Standing time, Timed Up & Go) were evaluated. [Results] There was a significant increase in the physical fitness and balance ability of the exercise group. [Conclusion] The Swiss ball exercise program had a positive effect on physical fitness and balance ability of elderly women. We consider that the ball which is easy, safe and interesting to use will encourage the elderly’s active participation in exercise.