BACKGROUND: Short and long-term breast cancer treatment side-effects allied with the increase of sedentary behavior, affect quality of life (QoL). Nonetheless, regular physical exercise appears to ameliorate breast cancer survivor (BCS) QoL components. PURPOSE: to analyze the effect of 24 weeks of mat Pilates (3 times/week, 60 min session) in BCS receiving hormone therapy on QoL components. MATERIALS AND METHODS: 43 participants were randomized according to hormone therapy (Tamoxifen (TMX) or Aromatase Inhibitors (AIs)) in the Pilates group (PG) and control group (CG). The QoL data was collected through SF-36, EORT-30, and 23 questionnaires. The evaluations occurred at baseline (T1), at week 12 (T2), and week 24 (T3) of the intervention. The generalized estimating equations model was used with the Bonferroni post hoc test (p <
0.05). RESULTS: The SF-36 showed that CG improved physical limitations at T2 compared to T1 (p = 0.032). The Pilates group enhanced emotional aspects compared to CG at T3 (0.009), social aspects at T3 compared to its baseline (p = 0.023), and mental health at T3 compared to CG (p = 0.026). The specific breast cancer questionnaires (EORT-30 and 23) did not show differences throughout the intervention. CONCLUSIONS: Only the SF-36 showed enhancement for PG QoL components. The EORT-30 and 23 domains are directly related to the side effect treatments, which could influence the outcomes.