Aims: Photovoice is a strategy to allow people to express their views and concerns about health. This project aimed to promote physical activity (PA) among patients with chronic illness, identify facilitators and barriers for PA, enhance walking within the neighbourhood, and build up efficacy in doing exercise. Design: A quasi-experimental study with waitlisted control and pre-and-post measures. Setting: Community elderly centres. Participants: A total of 204 older adults with diabetes and/or hypertension were recruited. They were assigned to either intervention group (IG) or waitlisted control group (CG). Intervention: Under the supervision of a nurse, six weekly group meetings were arranged in community elderly centres in which the participants freely exchanged their views about the barriers and facilitators of regular physical activity. Participants were encourage to take photos in their neighbourhood or at homes, and brought these photos for sharing in the group meetings. The photos showed the barriers and the facilitators to PA. In the last meeting, each participant worked out a plan to perform PA in the coming four weeks. Measures: PA referred to the number of steps taken per day and it was measured by Garmin Accelerometer at baseline, at Week 6 and Week 10. Other measures include the 9-item Self-efficacy Scale for Exercise - Chinese version (SEE-C), the 23-item Chinese Barriers to Exercise Scale and Senior Fitness Tests. General linear mixed model was used to compare the outcomes between IG and CG after the intervention. Results: After the 6-week intervention, the average number of steps taken by the IG participants increased. At Week 10, there was a significant higher proportion of the IG participants who had increased at least 1,200 steps than that of the CG (Estimate=0.151, SE=0.066, p<0.05). The lower body strength of the IG participants was significantly higher than that of the CG (mean difference = 0.94, t=1.957, p<0.05) and the lower limb flexibility of the IG participants was also significantly higher than that of the CG (mean difference = 2.04, t=2.397, p<0.05) at Week 10. Conclusion: Understanding older adults’ views and thoughts about barriers to PA through photos and group discussion seemed to be a good strategy to motivate older adults with chronic illnesses to commit to regular physical activity. This photovoice intervention improved the participants’ physical activity level and physical fitness, particularly in lower limb flexibility and body strength.