Background <p>Pregnancy induces physiological and psychological changes that require adaptation. Pilates, combining aerobic, strength, and flexibility exercises, is considered a safe and effective method to improve maternal and fetal outcomes. While studies highlight its benefits, a scoping review addressing the comprehensive effects of Pilates during pregnancy is lacking. This study aimed to comprehensively review the effects of Pilates during pregnancy, focusing on type, duration, frequency, practitioners, and parameters it influences.</p> Methods <p>A scoping review was conducted following Arksey and O’Malley’s framework and PRISMA-ScR guidelines. Six databases (PubMed, Scopus, Web of Science, PEDro, Cochrane Library, and CINAHL) were searched using MeSH terms. Studies published between January 2014 and September 2024 were included. Twenty-one studies meeting the inclusion criteria were analyzed for type, duration, frequency, practitioners, and outcomes.</p> Results <p>Most studies examined the effects of Pilates on sleep quality (<i>n</i> = 6), pain (<i>n</i> = 6), depression (<i>n</i> = 5), incontinence (<i>n</i> = 4), and disability (<i>n</i> = 4). Pilates showed significant effectiveness across these parameters. Traditional Pilates (<i>n</i> = 10) was the most commonly used method, followed by online, pregnancy-specific, and clinical Pilates. The exercise duration ranged from 4 to 16 weeks, with twice-weekly sessions being the most common. Practitioners were primarily Pilates instructors (<i>n</i> = 9) and physiotherapists (<i>n</i> = 6), with one study involving a midwife.</p> Conclusion <p>Pilates is effective for improving sleep quality, pain, depression, and other maternal health outcomes during pregnancy. Variations in method, frequency, and practitioners highlight the need for standardized protocols to optimize its benefits. This review provides insights for healthcare professionals to incorporate Pilates in prenatal care.</p>