Background: Although widely used in clinical practice, evidence on the effectiveness of the Pilates method in people with neck pain has not been adequately summarised yet. Objective: To systematically review the literature on the effectiveness of the Pilates method on improving pain and disability in patients with neck pain. Methods: We performed searches in multiple databases from their inception to October 2021. We included randomised controlled trials comparing the effects of the Pilates method with other treatments on pain and disability in patients with neck pain. Two authors independently selected studies, rated risk of bias, extracted data, and judged the overall certainty of evidence using GRADE. Results: We included five RCTs (n = 224 participants). There is low certainty evidence that Pilates method did not significantly improve pain compared to other treatments at short-term (mean difference (MD): MD: 9.29 points, 95% CI -25.84 to 7.26; I2 = 93%). Low certainty evidence suggested that the Pilates method did not significantly improve disability compared to other treatments at short-term (MD: 3.20 points, 95% CI -7.70 to 1.30; I2 = 75%). Conclusion: Based on low certainty evidence, the Pilates method is not better than other treatments at 3 months to reduce pain and disability. High quality trials are required.