Introduction: practice of physical activity and the ketogenic diet monitoring can have a double effect in helping in processes of weight loss and improvement of body composition and lipid profile. Objective: the objective of this review was to investigate the work done with obese patients who undertook a ketogenic diet and a physical exercise program, as well as to calculate the overall effect size in terms of improvements in fat mass, through a meta-analysis. Methods: the selection of studies was based on the following criteria: experimental studies; a) experimental studies (randomized controlled designs) and quasi-experimental (e.g. pre-test/post-test); b) studies with low-carbohydrate diet ( 35%); c) studies were admitted exclusively with subjects that facility overweight or obesity (BMI > 25; and d) with measurements of body composition and/or Lipid profile at the beginning and end of the intervention. Results: for the methodological review, 7 articles and 3 reviews were analyzed. All studies, whether by establishing aerobic or strength training and show significant weight loss in all outcomes. Conclusions: comparing different types of exercise, we could say that interventions based on endurance exercise reported a decrease in muscle mass, however there was a maintenance, and even an increase, in studies with resistance exercises. Meta-analysis showed significant results at the global level with a medium heterogeneity, therefore, there will be greater reduction of fat mass in groups that realize diets with low carbohydrates and exercise that in those who do not undertake this type of diet, and those only perform exercise.