Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine that commonly manifests during puberty and may result in cosmetic, functional, and cardiopulmonary complications. Although surgical intervention is generally reserved for severe cases, non-operative treatments especially therapeutic exercises are increasingly recognized as effective approaches for managing mild to moderate scoliosis. This review seeks to synthesize the current evidence regarding exercise-based interventions for AIS and to assess their efficacy in managing spinal curvature and enhancing functional outcomes. A systematic literature search was performed using Medline, CINAHL, and the Cochrane Library to identify studies published between 1990 and 2024. Studies were included if they focused on AIS populations, employed therapeutic exercise as the primary intervention, and reported outcomes related to the Cobb angle. Eight randomized controlled trials (RCTs) met these inclusion criteria. Scoliosis-specific exercise programs, such as the Schroth method and the Scientific Exercise Approach to Scoliosis (SEAS), demonstrated significant reductions in Cobb angles and improvements in posture, balance, and quality of life. Interventions combining exercise with bracing were more effective than bracing alone. Additionally, breathing exercises contributed to enhanced thoracic mobility and pulmonary function. Therapeutic exercise appears to be a safe and effective conservative treatment modality for AIS. When integrated with bracing, it may further promote curve stabilization and functional performance. Nonetheless, further standardized, long-term studies are warranted to optimize exercise protocols and validate these outcomes.