Regular exercise can improve wellbeing, yet data are scarce on how persons with disabling conditions may benefit from active lifestyles, due to the complexities of exercise prescription in this population. A novel medical concept for exercise prescription called activity pacing is the subject of this review, which identifies the potential for this strategy to optimally integrate existing medical and sports medicine approaches in promoting physical activity in persons with disabling conditions. Activity pacing is a goal-directed behavioural process of empowering people to confidently develop decision-making and planning over how and where to distribute available energy across daily activities. Currently, different conceptual traditions and definitions of pacing exist with important implications for the implementation and subsequent effectiveness of activity pacing. Application of activity pacing has mostly focused on symptom-reduction to improve self-regulatory behaviour, and less on physical activity stimulation for health and wellbeing. Further studies and greater connection between medical and sports science research are needed on how to adapt, tailor and optimise activity pacing to make it successful. The potential of activity pacing to increase physical activity and lessen fatigue could be a powerful tool to help fight the growing incidence of physical inactivity, particularly in persons with disabling conditions.