Population aging is a global phenomenon that has wide-ranging consequences for the health of individuals, including age-related obesity, muscle loss, and a decline in muscle strength and gait speed. These alterations are associated with disability, functional decline, and mortality in older adults. The objective of this study was to analyze the effects of Pilates exercises on body composition, handgrip strength, and physical performance among community-dwelling Spanish women aged 60 and older. A randomized controlled trial of a 12-week Pilates training program was conducted. A total of 109 women were randomly allocated to either a control (n = 54) or a Pilates (n = 55) group. Body composition was evaluated by bioelectrical impedance. Body mass index (BMI), percentage of body fat, and height-adjusted skeletal muscle mass index (SMI) were assessed before and immediately after the intervention, as were physical performance, estimated by gait speed (timed up-and-go test), and handgrip strength. Statistically significant improvements (p < 0.05) were observed both within and between groups for handgrip strength (Cohen's d = 0.40 and 0.52 respectively) and gait speed (Cohen's d = 0.86 and 0.87 respectively). After 12 weeks, BMI significantly decreased (Cohen's d = 0.07) only in the Pilates group. No significant differences were observed regarding SMI. In conclusion, a 12-week Pilates exercise intervention on community dwelling women over 60 years old shows beneficial effects on muscle strength, physical performance, and BMI, but failed to induce any changes on body composition.

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