Background: Back stabilization exercises have been applied to decrease low back pain. Pilates exercise can help stabilize the low back and pelvic alignment, and uses equipment such as cadillac, reformer, chair, and barrel. Objectives: This study was conducted to confirm the effects of pilates exercise using cadillac equipment and self-exercise using back pain educational materials on pain, pelvic inclination, and single leg stance ability in adult women with back pain. Design: Randomized controlled trial. Methods: Twenty-five participants (female 25) with unspecified low back pain with lumbar hyperextension and anterior pelvic tilt were recruited. 25 adult women with back pain were randomly divided into a pilates group and a selfexercise group. Pilates exercise intervention using a cadillac was administered to the pilates group, and posture and lifestyle education materials for back pain were provided to the self-exercise group. All of the interventions were conducted 3 times a week for 4 weeks, 50 minutes per session, and the results are as follows. Results: Data analysis in each group revealed statistical differences between self-exercise and divided into a Pilates intervention. A visual analog scale (VAS)/oswestry disability index (ODI) decreased pain in both groups, Independent t-test decreased pain in both groups, but there was no significant difference. Data analysis divided into a pilates group revealed statistical differences between a VAS/ODI and pelvic tilt angle and static balance. It has been shown to increase scores or relieve pain. Conclusion: Through this study, it was confirmed that the pilates exercise using cadillac can be effectively used to reduce back pain, improve pelvic alignment, and improve single leg stance ability in adult women with low back pain.