This study investigated the impact of a water-based Thai dance routine on balance, muscle strength and endurance, quality of life, and blood glucose levels among elderly individuals. Participants were 128 women aged 60 to 70 from the Chaiyaphum Elderly Club, divided equally into an experimental group and a control group. Assessments were conducted at three intervals: before training, after six weeks, and after twelve weeks. Both one-way and two-way ANOVAs with repeated measures were employed, and Bonferroni's method was used for mean difference comparisons. Results showed that the experimental group, who engaged in the water-based Thai dance routines, exhibited significant improvements in static and dynamic balances, enhanced muscle strength and endurance, better quality of life, and maintained normal blood glucose levels compared to the control group (p < .01). Notably, improvements were more significant after twelve weeks of training than after six weeks. Conversely, the control group showed a slight decline in static balance after twelve weeks, although there were no significant changes in dynamic balance, muscle strength and endurance, quality of life, or blood glucose levels at any stage of the study.