Background: The objective of this study was to determine the effect of a home-based exercise program on fatigue, anxiety, quality of life, and immune function of thyroid cancer patients taking thyroid hormone replacement after thyroidectomy. Method: This quasi-experimental study with a non-equivalent control group included 43 outpatients taking thyroid hormone replacement after thyroidectomy (22 in experimental group and 21 in control group). After education about the home-based exercise program, subjects in the experimental group underwent 12 weeks of aerobic, resistance, and flexibility exercise. Analysis was conducted between the two groups. Results: Patients in the experimental group were significantly less fatigued or anxious (both p < 0.01). They professed significantly improved quality of life (p < 0.05) compared to those in the control group. Natural killer cell activity was significantly higher in the exercise group compared to that in the control group (p < 0.05). Conclusion: A home-based exercise program is effective in reducing fatigue and anxiety, improving quality of life, and increasing immune function in patients taking thyroid hormone replacement after thyroidectomy. Therefore, such home-based exercise program can be used as an intervention for patients who are taking thyroid hormone replacement after thyroidectomy.