Two girls, aged 10 and 17 years, both with perinatally acquired HIV infection, participated in a 12-week, hospital-based exercise rehabilitation program of progressive resistance exercise training with an aerobic component. Weight, height, skin-fold thickness (4 sites), lean body and fat mass (assessed by dual-energy x-ray absorptiometry), and visceral adiposity (assessed by single-slice CT scan) were measured at the start and at the competition of the training program. After 12 weeks of training, both girls showed improved muscle strength (up to 64% increase in some muscle groups) and decreased visceral adipose tissue (up to 23%) and subcutaneous adipose tissue (up to 21%). One child decreased her total body fat by 9%. No adverse effects of the program were seen. These preliminary data suggest that progressive resistance exercise training in a medically supervised environment is safe and feasible for children with HIV infection. Most of these improvements were sustained or had increased at follow-up after home-based training.