SummaryResearch demonstrates a positive and graded relationship between handweighted exercise energy costs, the distance through which handweights are swung and the weight used. The energy costs of handweighted exercise when swinging 0.45 to 1.36kg handweights have been shown to be 3 to 155% greater than costs of unweighted exercise at any pace. The upper limit of such increases is unknown. Moreover, the use of handweighted arm swings can convert walking, benchstepping or running from leg dominated endurance training modalities to exercises that simultaneously challenge muscles of both the upper and lower body.The use of handweights may induce a pressor response characterised by elevated heart rate and blood pressure responses at a given exercise intensity. However, such elevations have not been consistently reproduced and when they occurred, were on average small and of little physiological concern. Individual blood pressure responses may vary more widely between hand-weighted and unweighted walking, with some exhibiting higher and others lower blood pressures when using handweights. Taken together, research suggests that the prescription of handweighted exercise is safe for most individuals. However, it should be prescribed using precautions similar to those used when implementing new exercise regimens, particularly among those with cardiovascular complications. Potential strength and endurance training adaptations to handweighted exercise that incorporates large arm and leg range of motion movement patterns have yet to be determined.