This study aimed to explore the acute effects of aerobic and resistance exercise on craving, as well as their emotional and cognitive impacts in individuals with methamphetamine use disorder (MUD). Thirty-five male participants with MUD completed a within-group crossover design, involving three randomised tasks: a moderate-intensity aerobic exercise task (AET), a moderate-intensity resistance exercise task (RET), and a control task (COT). Craving and immediate emotional states were assessed at multiple time points before and after each task. Cognitive functions, including attentional bias, working memory, inhibitory control, and cognitive flexibility, were also evaluated before and after the tasks. Both AET and RET significantly reduced craving compared to the COT during and after the tasks. Participants in both exercise conditions reported higher positive emotional states (happiness, excitement) compared to COT, with no significant changes in other emotional states. Cognitive assessments revealed that attentional bias and working memory were lower following exercise tasks compared to COT, while no significant changes were found in inhibitory control or cognitive flexibility. Notably, attentional bias was identified as a mediator in the relationship between exercise and craving reduction. The effects of AET and RET were similar across all outcome measures. These results suggest that both aerobic and resistance exercises are effective in reducing craving and enhancing emotional and cognitive factors in MUD, particularly through improvements in attentional bias and working memory. These findings have implications for developing exercise-based rehabilitation strategies and highlight the need for further research in this area.

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