Objectives: To identify and evaluate the characteristics and methodological quality of the studies that have proposed Pilates as a rehabilitation strategy for women with breast cancer and to determine its benefits on health outcomes in this population. Methods: A systematic review and meta-analysis were conducted. Medline/PubMed, Pedro, SPORTDiscuss, Scopus and Web of Science were systematically searched up to January 2017. The methodological quality was evaluated by means of the Jadad Scale and the Quality Assessment Tool for Before-After Studies with No Control Group. Risk of bias was assessed by means of the Cochrane Collaboration's tool. Results: Five randomized controlled trials and two un-controlled studies were selected. Four of the randomized controlled trials were pooled in the meta-analysis for effects of Pilates on shoulder range of motion, quality of life, pain, and self-reported upper extremity function. According to the findings reported in the studies analysed in the review, Pilates had a positive and significant effect on the aforementioned variables, as well as on functional status, mood, fitness and upper extremity circumference. The meta-analysis carried out showed that the effects that Pilates had on shoulder range of motion and quality of life, was not significantly greater than those resulting from other exercise programs. Conclusions: Pilates relieves the impact of breast cancer-related symptoms. These effects are not significantly greater than those derived from the performance of other therapies, with the exception of pain and self-reported upper extremity function. Systematic review registration number: PROSPERO CRD42018076852.