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Background: Increasing the elderly's balance through physical activity not only results in improved health and increases the independence of the elderly, but also reduces the heavy costs associated with the fall which imposed on family and society. Therefore, the purpose of this study was to investigate and determine the benefits of the Pilates exercises on the static balance, dynamic balance, and functional balance of the elderly. Materials and Methods: The papers which was published from March 2010 to 2018 were included in this study. The Pilates keywords were searched together with aging, elderly, and old subjects. The research literature was done in the Medline, Embase, Pubmed, Scopus, and SID databases. Results: The results of this meta-analysis indicated that the Pilates exercises had a significant and high effect size (P=0.000) on time up and go time (TUG) (Hedges g=1.078), the significant and moderate effect size on the functional balance (Hedges g=0.685), and the significant and low effect size on the static equilibrium (Hedges g=0.668). Conclusion: The results of this meta-analysis study showed that the Pilates exercises were effective exercises to improve static, dynamic, and the functional balance in the elderly subjects. More high-quality research is needed to examine the effect of the Pilates exercises on other aspects of the balance in the elderly as well as assess the effectiveness of the Pilates program in longer time and during the follow up program.