Latar Belakang: Nyeri punggung merupakan salah satu keluhan umum pada ibu hamil, khususnya trimester III yang dapat menurunkan kualitas hidup dan mengganggu aktivitas sehari – hari. Perubahan anatomi tubuh, peningkatan berat janin, serta perubahan hormonal berperan besar memicu munculnya nyeri ini. Penelitian ini bertujuan menganalisis efektivitas senam hamil terhadap penurunan nyeri punggung pada ibu hamil trimester III.Metode: Penelitian ini menggunakan desan pre eksperimental, desain one group pretest posttest design dengan jumlah sampe sebanyak 28 ibu hamil trimester III ditentukan berdasarkan Teknik purposive sampling. penelitian ini dilaksanakan di TPMB Asmak Mukhayah pada bulan Juni dan Juli tahun 2024. Instrumen penelitian berupa NRS untuk mengukur nyeri punggung dan SOP senam hamil. Data dianalisis menggunakan uji wilcoxon sign rank test.Hasil: Hasil penelitian menunjukkan sebelum diberikan intervensi sebagian besar responden mengalami nyeri sedang sebanyak 22 ibu hamil (78,6%), sesudah diberikan intervensi menunjukkan sebagian besar mengalami nyeri sedang sebanyak 16 ibu hamil (57,1%). Hasil uji wilcoxon menunjukkan nilai p = 0,000, yang berarti senam hamil efektif terhadap penurunan nyeri punggung pada ibu hamil trimester III.Kesimpulan: Senam hamil terbukti efektif dalam menurunkan nyeri punggung pada ibu hamil trimester III.Saran: Bidan diharapkan mengintegrasikan senam hamil ke dalam program antenatal care secara rutin sebagai upaya promotif dan preventif untuk meningkatkan kenyamanan ibu hamil dan mempersiapkan kondisi fisik menghadapi persalinan. Kata Kunci: Ibu hamil trimester III, Nyeri punggung, Senam hamil ABSTRACT Background: Back pain is one of the most common complaints among pregnant women, particularly in the third trimester, which can reduce quality of life and interfere with daily activities. Anatomical changes in the body, increased fetal weight, and hormonal alterations play a major role in triggering this pain. This study aimed to analyze the effectiveness of pregnancy exercise (senam hamil) in reducing back pain among third-trimester pregnant women.Methods: This study employed a pre-experimental design with a one-group pretest–posttest approach involving 28 third-trimester pregnant women selected using purposive sampling. The research was conducted at TPMB Asmak Mukhayah in June–July 2024. The instrument used was the Numeric Rating Scale (NRS) to measure back pain, and a standardized pregnancy exercise protocol was applied. Data were analyzed using the Wilcoxon signed-rank test.Results: The findings showed that before the intervention, most respondents experienced moderate pain (22 pregnant women, 78.6%), whereas after the intervention, the majority experienced mild pain (16 pregnant women, 57.1%). The Wilcoxon test results indicated a p-value of 0.000, demonstrating that pregnancy exercise was effective in reducing back pain among third-trimester pregnant women.Conclusion: Pregnancy exercise is proven effective in reducing back pain in third-trimester pregnant women.Recommendation: Midwives are encouraged to integrate pregnancy exercise into routine antenatal care programs as a promotive and preventive measure to enhance maternal comfort and prepare the mother’s physical condition for childbirth. Keywords: Third trimester pregnant women, Back pain, Pregnancy exercise