IntroductionDecreased physical activity is a major cardiovascular risk factor that is particularly pronounced in people living with HIV (PLHIV), who are more susceptible to endothelial dysfunction and accelerated atherosclerosis than the general population due to multiple mechanisms. The aim of the present study was to analyse whether regular physical activity is capable of improving endothelial function measured by flow‐mediated dilatation (FMD) in PLHIV.MethodsWe performed FMD measurement in 38 PLHIV, along with the assessment of their regular physical activity level using the International Physical Activity Questionnaire (IPAQ).ResultsFlow‐mediated dilatation results in PLHIV were 0.31 ± 0.06 mm and 7.34% ± 1.41% for absolute and relative FMD, respectively. IPAQ results showed that the average weekly level of physical activity was 3631.1 ± 1526.7 MET‐min/week, whereas the average daily sitting time was 287.3 ± 102.7 min/day. Predictors jointly accounted for 48% (adjusted value 42%) of FMD variance. Bootstrapped confidence levels revealed that physical activity had a statistically significant effect on the outcome [beta = 0.517, 2.5% confidence interval (CI) = 0.205, 97.5% CI = 0.752].ConclusionPhysical activity represents a widely available and uncostly tool that is capable of improving endothelial function and overall cardiovascular health in PLHIV.