Introduction: Physical activity (PA) is increasingly recognised in occupational therapy (OT) as a meaningful occupation supporting health, participation, and recovery. For women with serious mental illness (SMI), PA may offer benefits beyond fitness, including emotional regulation, identity reconstruction, and social connection. However, little is known about OT-facilitated PA in Croatian psychiatric settings.Aim: To explore and describe the lived experience and personal meaning of OT-facilitated PA among women with SMI in Croatian psychiatric settings.Method: A qualitative design using interpretative phenomenological analysis (IPA) was employed. Eight women with SMI who had participated in OT-facilitated PA within the previous six months were recruited purposively. Semi-structured interviews were conducted in Croatian, audio-recorded, transcribed verbatim, and analysed idiographically before cross-case theme development. MOHO informed interpretation of occupational dimensions.Findings: Five master themes were identified: movement as regulation and relief; PA as reclaiming self, agency, and personhood; PA participation shaped by structure, relationships, and choice; PA negotiated under constraints and trade-offs; and PA as connection with vulnerability.Conclusions: PA was experienced as meaningful occupation shaped by autonomy, symptoms, fatigue, institutional context, and relational support.Significance: The study supports OT practice by showcasing choice, flexibility, relational support, and recovery-oriented PA interventions within psychiatric services.