The purpose of this study was to examine the effects of a six-month Square-Stepping Exercise (SSE) program on physical fitness and cognitive function in elderly and the effects of differences in cognitive function levels before the program on cognitive function. Twenty-four elderly (≧75 years old, mean age: 80.7±3.8 years) participated in the SSE program (once a week, 90 minutes/session, for six months). Grip strength, single leg balance with eyes open, chair stand, figure-8 walking test, and cognitive function (Five Cog) were measured before and after the program. Physical function did not improve during the SSE program. Significant memory and language improvements in Five Cog were observed. There was no significant interaction between the pre cognitive function level and the pre results. In conclusion, the six-month SSE program is an effective exercise for improving memory and language in cognitive function of elderly women and prevented physical function decline. However, there was no difference in the improvement due to the pre cognitive function level.