Deterioration of physical and psychological health is an important issue in older adults aged 65 years or more. This study aimed to determine whether a virtual kayak paddling (VKP) exercise could improve postural balance, muscle performance, and cognitive function in older adults with mild cognitive impairment. Sixty participants were randomly assigned to the VKP (n = 30) or control group (n = 30). Participants in the VKP group performed the paddling exercise in a virtual environment for 60 min twice a week for 6 weeks, whereas those in the control group performed home exercises. Postural balance (p < .05), muscle performance (p < .05), and cognitive function (p < .05) were significantly improved in the VKP group and were superior to those in the control group (p < .05). Thus, the findings indicate that VKP exercise improves postural balance, muscle performance, and cognitive function in older adults with mild cognitive impairment.