The aim of this study was to investigate the effect of pilates on balance, coordination, quality of life and fear of falling in the elderly. The study was conducted through the participation of 55 volunteers all of whom were over 65 years of age. The mean age was 77.09 ± 8.07 years. The individuals were divided into three groups: pilates group (n=19), gait group (n=18) and sedentary group (n=18). The pilates group participated in a 30-minute exercise program for 2 days a week for 3 months, and the gait group participated in a 30-minute brisk walking session 2 days a week for 3 months. SF-36 quality of life scale, Rivermead mobility test, Tinetti balance test and Tampa scale of kinesiophobia were applied to each group at the start of the study and the evaluations were repeated after the 3-months program. Pre- and post-exercise evaluation results of the pilates group demonstrated that there were significant changes in all the sub-parameters of the SF-36 quality of life scale (p<0.05). In addition, there was a significant difference in physical role limitation, emotional role limitation, pain and social function scores when compared with the control group (p<0.05). Significant differences were found in the pilates group between the pre- and post-exercise Tinetti balance and walking tests (p<0.05). Comparing the pilates and control groups, a significant difference was found in the walking test (p<0.05), while no significant difference was found in the balance test. However, in the Tampa Scale of Kinesiophobia, there was a significant improvement in the pilates group (p<0.05). A significant difference was also observed in the pilates group according to the Rivermead mobility index (p<0.05). Consequently, it was concluded that a 12-week Pilates exercise program has the potential to increase the quality of life, balance coordination and mobility while decreasing the fear of falling.