Abstract: Background: Pilates has been advocated to be of benefit for patients with low back pain (LBP). The aim of this study was to investigate the possible benefits of attending Pilates classes for patients who had completed standard physiotherapy treatment but still had some symptoms. Methods: Ethical approval was obtained. All LBP patient charts (n=181) who had completed physiotherapy treatment in the participating hospital during a 6 month period were screened for study inclusion. 29 women (16%) were recruited into the study. Subjects were randomly allocated either to attendance at a one hour Pilates mat class consisting of modified Pilates exercises for 8 weeks (n=15) or no further intervention (n=14). Outcome measures were evaluated by a blinded assessor using Visual Analogue Scale (VAS) for pain, Roland Morris Disability Questionnaire for disability and Sahrmann Abdominal Test for lumbopelvic control before and after the 8 week intervention period. Results: Statistical Package for the Social Sciences (SPSS) version 15.0 was used to analyse data. The Mann-Whitley U test was used to identify any significant changes between the groups. There was a statistical (p=0.047) but not clinically significant improvement in pain in the Pilates group (9.5mm mean change on VAS) compared to the control group (−4.7mm). No significant difference in disability was noted between the groups at follow up (p=0.301). A trend towards improvement in lumbopelvic control was observed in the Pilates group. Conclusion: Despite the small sample size this study provides some evidence to support the use an 8 week Pilates class to improve pain in women with ongoing LBP who have completed conventional physiotherapy treatment.