Objective: The main objective of this study was to explore patients' perceptions of general practitioner (GP) exercise referral (ER) schemes with a view to providing a better service for future patients. Design: A qualitative focus group methodology. Setting: Meeting rooms or communal areas in leisure centres across North Yorkshire. Method: Thirty participants took part in six focus groups. Data were analysed using a content analysis technique based on the "framework" approach. Results: Participants were generally very positive about the ER schemes and reported numerous benefits including: improved self-confidence, wellbeing and quality of life; increased physical activity behaviour and awareness; and improved physical health and fitness. Access to the ER scheme appeared to be restricted due to a lack of awareness amongst primary health care staff. Participants were content with the activities provided by the leisure centres, but felt that there should be more group activities and opportunities to meet other people. Conclusion: Findings from this study provide support for the use of ER schemes for promoting physical activity and improving health. Despite existing evidence supporting a move towards promoting informal, unstructured, unsupervised physical activity, ER schemes provide participants with support, supervision, structure and opportunities for social contact, which act as powerful motivators for some people. In terms of a population approach, however, the ER scheme must be considered as just one method for promoting physical activity, and must be part of a broader strategy encompassing a wide range of initiatives in a number of settings. (Contains 2 tables.)