PURPOSE: To determine the effect of Pilates exercises on pain, endurance, quality-of-life, and disability in post-menopausal women with low back pain. METHODS: After obtaining signed written consent, 128 women in the post-menopausal stage were randomly allocated to two groups: group 'A' (experimental) and group 'B' (control-conventional). The participants underwent evaluations for disability using the Oswestry Disability Scale. Pain levels were recorded using a numerical pain rating scale (NPRS), while endurance was tested using the Krause Weber test. Quality of life (QOL) was evaluated using the Menopause-Specific Quality of Life (MENQOL) Questionnaire. RESULTS: Both the exercises Pilates (group A) and the conventional exercise (group B) showed improvement and compared to group B, group A showed significant changes in all outcome variables. CONCLUSION: Pilates training proves superior to conventional physical therapy for alleviating non-specific LBP and enhancing lumbar health in post-menopausal women. TRIAL REGISTRATION: Clinical Trials Registry-India (CTRI), CTRI/2024/04/065057. Registered on 02/04/2024.