Over 400,000 individuals in the US have Down syndrome (DS), the most prevalent genetic disorder. As a mother matures, her likelihood of having a child with DS increases. Trisomy 21 is a chromosomal abnormality associated with Down syndrome. Due to anomalies in the central nervous system's maturation, these changes are to blame for the delay in motor and cognitive development. The aim of this study was to determine the effect of rhythmic aerobic exercises for improving functional balance in children with DS. This investigation was a randomized controlled trial. Forty patients were split into two groups, with the experimental group doing combination of rhythmic aerobic activities, strength and balance exercises twice a week for 30 minutes each session for a total of eight weeks. After utilizing rhythmic auditory stimulation through a portable device with 8 beats at first, then advanced to 16 beats per minute in experimental group. Only strength and balance exercises were done with the control group. The patient's functional balance was evaluated by comparing the patient's sit-to-stand and stand-to-sit performance on the appropriate Pediatric Balance Scale and Timed Up and Go test sections. Among 36 participants, 15 (41.7%) were male and 21 (58.3%) were female. In current study results show experimental group shows better result than control group. The results of Pediatric Balance Scale after intervention were 34.56±3.053 p<0.002 and for Timed Up and Go test was 14.44±2.064 p<0.000. Conclusion This controlled trial concluded that there was significant effect of rhythmic aerobic exercise on functional balance in children with Down syndrome.