Purpose: In this study a pilates exercise program using self-efficacy sources was provided for women 65 years of age or older and the effects on physical fitness, body composition, depression, self-efficacy, and health-related quality of life were tested. Methods: A quasi-experimental study employing a nonequivalent control group, pre-post design was conducted. The subjects consisted of 30 older women in the experiment group and 30 in the comparison group. The intervention was conducted twice a week for a period of 12 weeks. During this period, the pilates exercise program using self-efficacy sources (health education, phone coaching, mentoring, checking homework, recreation) were provided in the experiment group and pilates exercise program were offered in the comparison group. Chi-square test, independent t-test, ANCOVA were used for data analysis. Results: Following completion of the program, upper muscle strength (F=4.131, p=.047), low muscle strength (F=5.558, p=.022), upper flexibility (F=5.252, p=.026), static balance (F=5.957, p=.018), dynamic body balance & agility(F=18.971, p<.001), endurance(F=10.058, p=.002), muscle mass (F=5.748, p=.020), depression (F=4.493, p=.038), Self-efficacy (F=33.853, p<.001), and Health-related quality of life(F=5.586, p=.022) were significantly better in the experimental group. Conclusion: Findings from this study indicate that the pilates exercise program using self-efficacy sources are effective in enhancing physical fitness, body composition, self-efficacy and health-related quality of life and in decreasing depression for female elders and could therefore be regarded as positive program for promotion of physical and mental health for older women.