The perception of effort during exercise and its relationship to fatigue is still not well understood. Although several scales have been developed to quantify exertion Borg's 15-point ratings of perceived exertion (RPE) scale has been adopted as a valid and reliable instrument for evaluating whole body exertion during exercise. However, Borg's category-ratio scale is useful in quantifying sensations of exertion related to those variables that rise exponentially with increases in exercise intensity. Previous research has examined the extent to which afferent feedback arising from cardiopulmonary and peripheral variables mediates the perception of exertion. However, the literature has not identified a single variable that consistently explains exertion ratings. It is concluded that effort perception involves the integration of multiple afferent signals from a variety of perceptual cues. In a process defined as teleoanticipation, the changes in perceived exertion that result from these afferent signals may allow exercise performance to be precisely regulated such that a task can be completed within the biomechanical and metabolic limits of the body. The accuracy with which individuals can regulate exercise intensity based upon RPE values, the decrease in muscle recruitment (central drive) that occurs before fatigue, and the extent to which perceived exertion and heart rate can be altered with hypnosis and biofeedback training all provide evidence for the existence of such a regulatory system. Future research is needed to precisely quantify the extent to which efferent feedforward commands and afferent feedback determine pacing strategies such that an exercise event can be completed without irreversible tissue damage.