Postoperative exercise can safely enhance recovery for patients with colorectal liver metastases, improving outcomes without increasing adverse events.

• Serious adverse events were similar in both exercise and control groups.
• Non-serious adverse events were significantly lower in the exercise group, with a reduction of nearly 5 events.
• Patients in the exercise group started chemotherapy earlier (25 vs. 42 days) and needed fewer dose modifications.

Consider integrating early postoperative exercise to improve patient recovery and quality of life.