Objective To study the feasibility and effectiveness of in-bed bicycle exercise in enhanced recovery of ICU patients after abdominal surgery. Methods A total of 96 patients who met the inclusion criteria were randomly divided into 2 groups of 48 cases each. The control group performed traditional in-bed exercise, while the intervention group additionally performed in-bed bicycle exercise, 20 min each time, twice a day. Results Eighty six patients completed the study, 46 in the intervention group and 40 in the control group. There was no statistical difference in the implementation rate of exercise within 48 h between the two groups (P>0.05). The implementation rate of exercise during hospitalization in the intervention group was significantly higher than that of the control group (P＜0.01). The reason of exercise cessation had no significant difference between the 2 groups (P>0.05). Two groups had no catheter displacement, damage and other adverse events during exercise. The duration of mechanical ventilation and ICU stay in the intervention group were significantly shorter than those in the control group (P<0.05 for both); the lower limb muscle strength, the numbers of patients sitting and standing at the bedside were significantly higher than those in the control group (P<0.05 for all). Conclusion ICU patients had good adherence to in-bed bicycle exercise, which didn′t increase the occurrence of adverse events. Bicycle exercise can improve lung function and lower limb motor function of ICU patients after abdominal surgery, and promote accelerated recovery of them.