Abstract: Objective: To evaluate the effect of lower limb muscles strength exercise based on self-efficacy theory among elders in nursing institution. Methods: We recruited 52 elders in nursing institution during April 2014 to August 2014. According to the different floors, we divided them into the experimental group and the control group with 25 in the experimental group and 27 in the control group. The experimental group received lower limb muscles strength exercise based on self-efficacy theory three times a week for 16 weeks, while the control group received routine care in nursing institution.Results: The adherence rate of lower limb muscles strength exercise was 88%. After the interventions, there were significant differences in the time of Five-Times Sit-to-Stand Test and exercise self-efficacy scores between the two groups (P<0.05).Conclusion: Lower limb muscles strength exercise based on self-efficacy theory could improve the elder's lower limb muscle strength and exercise self-efficacy, and improve their exercise adherence and enhance the exercise effect.