One hundred twenty-nine women with mobility impairment following hip fracture were randomized to receive supervised high-intensity exercise plus topical testosterone gel (n=55), exercise plus placebo gel (n=54), or enhanced usual care (n=20). The primary outcome was change in 6-minute walking distance (6MWD) from baseline to 24 weeks. Secondary outcomes included changes in Short Physical Performance Battery (SPPB) scores, lean body mass, grip strength, and other functional and patient-reported outcomes. Outcomes were assessed at 12 and 24 weeks. Overall, the results revealed no significant differences in 6MWD between the testosterone and placebo groups (mean change: 42.7 m vs 40.5 m, P=.85). However, the testosterone group had greater improvement in SPPB scores (1.5 vs 0.7; P=.009). These findings suggest that while topical testosterone does not enhance long-distance mobility, it may improve short-distance physical performance when combined with exercise.