This study aimed to investigate the effects of a foam roller-based combined exercise program on functional fitness, balance ability, and gait in women aged 65 years and older. Using a 2×2 mixed design, the study compared variables measured before and after a 6-week foam roller-based combined exercise program. A total of 32 old women were randomly assigned to either the foam roller-based exercise group or the control group. The intervention was conducted 3 times a week for 6 weeks, with each session lasting 60 min. The senior fitness test, gait test, Fullerton advanced balance test, and Y-balance test were performed at baseline and postintervention. Participants in the combined exercise group demonstrated significant improvements in upper and lower-body strength, lower extremity flexibility, agility, walking speed, stability, and balance ability. These findings confirm that a foam roller-based combined exercise program incorporating stretching, strength training, and aerobic components is effective in enhancing functional fitness, balance, and gait in older women. The inclusion of props such as foam rollers may help facilitate proper exercise form and activate diverse muscle groups, thereby augmenting the overall efficacy of exercise interventions.