Coronary artery disease (CAD) remains a leading cause of mortality worldwide, with obesity being a significant risk factor that exacerbates CAD outcomes. Exercise-based cardiac rehabilitation (CR) has emerged as a crucial intervention for managing CAD, offering benefits such as reduced cardiovascular mortality and improved health-related quality of life (HRQoL). This review aims to evaluate the clinical effectiveness and cost-effectiveness of exercise-based CR in patients with CAD, including those with obesity, focusing on quality of life and cardiovascular outcomes.