Resumen: Purpose: Cancer significantly impairs patients' quality of life and physical function. The Pilates method, a mind-body exercise emphasizing breath control and movement precision, has been associated with improvements in strength, balance, pain reduction, and immune modulation. This systematic review evaluates the effectiveness of Pilates compared to conventional interventions in improving pain and functionality among individuals with cancer. Methods: A systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42024540950). Studies comparing Pilates with other interventions in adults with cancer and assessing outcomes such as pain, quality of life, and strength were included. A comprehensive search was performed across multiple databases without language or date restrictions, using keywords including “Pilates,” “Neoplasms,” and “Cancer.” Methodological quality was assessed using the MINORS and PEDro tools. Results: The Pilates method demonstrated benefits in quality of life and the reduction of nocturia in patients with prostate cancer. Significant improvements were observed in shoulder range of motion, muscle strength, and physical well-being (FACT-B), along with increased aerobic capacity (6MWT). Although changes in fatigue, stress, sleep, and depression were not statistically significant, they showed positive trends. Additionally, pain (VAS, BPI) and disability (Constant-Murley) decreased in the groups that practiced Pilates. Conclusions: This systematic review shows that Pilates-based interventions can be as effective as other physical exercise modalities in improving quality of life and functional well-being in cancer patients, particularly in those with active breast cancer and in survivors.