86 patients with chronic low back pain were randomized to receive either mat-based or equipment-based Pilates. The purpose of this study was to compare efficacy between interventions in reducing pain and disability. Results indicated significant within-group improvements from baseline in pain intensity and disability for both groups. Patient-specific disability, global impression of recovery, and kinesiophobia scores improved significantly as well (except for kinesiophobia at 6 months in the mat-based Pilates group). Between-group differences in improvement from baseline in disability, patient-specific disability and kinesiophobia scores were significant at 6 months, in favour of equipment-based Pilates. Improvement in pain intensity was comparable between groups.