Fibromyalgia causes a decrease in physical function, quality of life and a higher prevalence of mental health-related diseases. Pharmacological treatment is the most used in patients with fibromyalgia, but a correct approach to the therapeutic process should include the practice of physical exercise. Physical activity causes improvements in symptomatology, aerobic capacity, physical function and subjective perception of general well-being and self-efficacy. Therefore, the aim of the present study is to develop an update of the state of the art related to aquatic exercise in patients with fibromyalgia, as well as to know the main benefits of this type of interventions. For the search, compilation and selection of articles, the keywords "fibromyalgia" and "aquatic exercise" were used, which were entered in the Scopus, Web of Science and PubMed databases. To adjust the search to the object of study, a series of inclusion criteria were established for the scientific publications. The studies analyzed show that aquatic exercise is an effective and complementary alternative to conventional therapy. Among the benefits of aquatic exercise are a decrease in stress, a reduction in fatigue and an improvement in symptoms of depression and anxiety, as well as a decrease in pain and insomnia problems. In view of these results, it seems that aquatic physical exercise programs are a type of non-pharmacological treatment to be considered in the treatment of patients with fibromyalgia, improving symptoms and quality of life.