Objective This study aimed to evaluate the effects of a folk recreation program on the symptoms of people with dementia. The program was tailored to the participants' interest and derived from their traditional culture background. Methods A quasi‐experimental study design was used. A total of 48 participants were assigned to an experimental or a control group. The experimental group received a 40 to 50‐min folk recreation intervention, which is mainly about art, music and game, three times a week and for 16 weeks. The control group received routine care without special intervention. The Mini‐mental State Examination (MMSE), Barthel Index (BI) and the Chinese version of the neuropsychiatric inventory (CNPI) were used to estimate the cognitive function, ability of daily living and behavioral and psychological symptoms with dementia at baseline and week 16. Results For the experimental group, the mean scores of MMSE and BI increased significantly from baseline to week 16 (p < 0.01) for cognitive function and activity of daily living, and the mean score of CNPI‐symptom decreased significantly (p < 0.01) for behavioral and psychological symptoms. While, for the control group, the mean score of MMSE decreased significantly (p < 0.01), and the mean scores of BI and CNPI‐symptom changed non‐significantly. Conclusions The folk recreation program has the potential to improve cognitive function, ability of daily living and behavioral and psychological symptoms of the elders with dementia. The folk leisure activities, which embed in the participants' cultural background, will motivate their positive feelings and memories, can delay the progression of disease and improve the symptoms. Copyright © 2016 John Wiley & Sons, Ltd.