Exercise therapy is an important part of neurological physiotherapy and is widely used to improve physical and functional abilities in people with neurological disorders. Conditions such as stroke, spinal cord injury, multiple sclerosis, Parkinson’s disease, and traumatic brain injury may result in muscle weakness, impaired motor control, poor balance, reduced coordination, abnormal gait, and difficulty performing daily activities. Structured therapeutic activities can address these limitations when they are selected according to the patient’s clinical condition, functional capacity, and rehabilitation goals. This critical review examines the therapeutic applications of exercise therapy in neurological physiotherapy and its effects on major clinical and functional outcomes. It considers strengthening, aerobic conditioning, balance and coordination training, task-specific practice, gait rehabilitation, flexibility activities, and repetitive functional movements. Appropriate therapeutic programmes may improve muscle performance, mobility, walking ability, postural control, endurance, and independence in daily activities. However, treatment responses can differ depending on the neurological condition, severity of impairment, training intensity, frequency, duration, and patient adherence. The review further emphasises individualised programme planning, gradual progression, safety precautions, and regular assessment of functional changes. Overall, exercise therapy has a valuable role in neurological rehabilitation, although further well-designed studies are needed to establish optimal training strategies for different neurological conditions and patient populations.