Aim To investigate the effects of a simple home‐based exercise program on falls, physical functioning, fear of falling and quality of life in a primary care setting. Methods Participants (n = 439), aged ≥65 years with mild‐to‐moderate balance dysfunction were randomly assigned to an exercise (n = 219) or control (n = 220) group. The program consisted of five combined exercises, which progressed in difficulty, and a walking plan. Controls received fall prevention education. Physical functioning and other outcomes were measured at 3‐ and 6‐month follow‐up visits. Falls were monitored with fall diaries and phone interviews at 3, 6, 9, and 12 months respectively. Results The 12 months of the home‐based exercise program showed the incidence of falls was 0.30 falls per person year in the exercise group, compared with 0.40 in the control group. The estimated incidence rate ratio was 0.75 (95% CI 0.55–1.04), which was not statistically significant. The fear of falling (measured by the Thai fall efficacy scale) was significantly lower in the exercise than control group (24.7 vs 27.0, P = 0.003). Also, the trend of program adherence increased in the exercise group. (29.6% to 56.8%). Conclusions This simple home‐based exercise program showed a reduction in fear of falling and a positive trend towards exercise adherence. Further studies should focus on factors associated with exercise adherence, the benefits of increased home visits and should follow participants longer in order to evaluate the effects of the program. Geriatr Gerontol Int 2017; ••: ••–••.