Arteriosclerosis is one of the most common diseases that progresses to cardiovascular disease in ageing postmenopausal women. Early changes away from the poor lifestyle choices and the active management of risk factors can improve the survival of postmenopausal women. A network meta-analysis was performed to compare the effects of different exercise modes on the risk factors for arteriosclerosis in postmenopausal women. The primary outcomes were systolic and diastolic blood pressure, whereas the secondary outcomes included flow-mediated dilation (FMD), brachial-ankle pulse wave velocity (baPWV), and total cholesterol/high-density lipoprotein. Randomised controlled trials on the effects of exercise on arteriosclerosis in postmenopausal women were identified in 10 databases (PubMed, Cochrane Library, Embase, Web of Science, EBSCO, CNKI, SinoMed, VIP, Wanfang Data, and Wanfang Med Online). Sixty-four studies (2460 particpants) were eventually included. Among postmenopausal women with hypertension, continuous aerobic exercise (CAE) was most effective in reducing systolic and diastolic blood pressure. Among those without hypertension, high-intensity interval training was the most effective in lowering blood pressure and increasing FMD, whereas CAE combined with resistance training was most beneficial in reducing baPWV. Exercise prescriptions for postmenopausal women should be tailored according to their blood pressure status to ensure the selection of the most suitable exercise modality and to maximize the effectiveness of the intervention. Trial registration: PROSPERO, registration number: CRD42022337536.