Objective <p>This study aimed to examine the effects of 8&#xa0;weeks of Pilates exercises, performed with and without equipment, on abdominal muscle strength and waist circumference in women over 30&#xa0;years of age.</p> Background <p>Pilates has become an increasingly popular exercise method for improving core stability and overall physical health, but limited research exists on its comparative effects with and without equipment in adult women.</p> Design <p>Randomized controlled trial (RCT).</p> Methods <p>A total of 45 women aged over 30 were randomly assigned to equipment-based Pilates (<i>n</i> = 15), non-equipment Pilates (<i>n</i> = 15), or control (<i>n</i> = 15). Both intervention groups trained three times weekly for 60&#xa0;min over 8&#xa0;weeks. The data were collected using demographic forms, waist circumference measurements, and the sit-up test. Statistical analyses included repeated-measures ANOVA, Scheffé post hoc tests, and paired-samples <i>t</i> tests, with effect sizes reported.</p> Conclusions <p>Pilates exercises, particularly equipment-based programs, are effective in reducing waist circumference body mass index and enhancing abdominal muscle strength in women over 30. These findings support the use of Pilates as a preventive and rehabilitative exercise method in women’s health practice. These results have practical implications for sports sciences, suggesting Pilates can be integrated into core stability and injury prevention programs for adult women.</p>