Falling is a very common phenomenon, with huge social and economic ramifications. It poses a serious risk to older adults, who are more prone to falls than younger patients and face more serious complications. Pilates is one of the most popular forms of exercise in the modern western world and some of its benefits include improving balance and posture, as well as strengthening the core. The objective of our review is to summarize recent findings on the benefits of Pilates for balance in older people who are at high risk of falling. Method: The following keywords were used to perform a search in English for the PubMed and Google Scholar databases: “Pilates and older adults and balance” for clinical studies published in the last decade. Results: Six clinical studies were included in this review involving a total of 273 older people at high risk of falling. Most studies have concluded that the Pilates method has a positive effect on balance, while one study found that it is not effective in improving balance in older adults. Discussion - Conclusions: The Pilates method can improve balance, mobility, and overall quality of life in older adults, as it reduces their risk of falling.