Body image attitude is closely associated with subjective well-being, emotional experience, and eating disorder symptoms. Exercise is a way that people often adopt to improve physical health and body shape. However, exercise does not always bring positive effects to body image attitude. For non-athletes, the motivation to participate in exercise is a key variable for their body image attitude. The level of body image satisfaction is generally decreased for those with a primary motivation to improve appearance, but increased for those with a primary motivation to promote health and physical function. As for professional athletes, elite athletes and athletes in sports which favor a lean body or low body weight are more likely to develop negative attitude toward their own body. Additionally, for some patients whose body image is seriously threatened by illness（e.g., breast cancer patients）, regular exercise could increase their body image satisfaction. The relationship between exercise and body image attitude among athletes, elite athletes, and special populations was reviewed in this study.