Background and Objectives: Obesity increaces inflammatory markers and causes insulin resistance, and exercise training plays an effective role in improving these markers. Therefore, the present study aimed to investigate the effect of eight weeks of Pilates training on C-reactive protein (CRP), insulin resistance, and body composition in middle-aged obese women.Materials and Methods: In this randomized clinical trial study, 20 obese middle-aged women were randomly assigned into two control and experimental groups. The experimental group participated in Pilates training for eight weeks, three times per week, each session lasting for 60 minutes. While, the control group did not do any special exercise. For all subjects, body composition indexes including body fat percent, weight, body mass index (BMI), waist circumference, hip circumference, waist to hip ratio (WHR), homeostasis model assessment of insulin resistance (HOMA-IR), and CRP were assessed prior to and after the training program. Data were analyzed using independent t-test and paired t-test.Results: Eight weeks of Pilates training significantly reduced the body fat percent, weight, and BMI in the experimental group (p<0.05). Moreover, significant improvement in HOMA-IR index was found in the experimental group (p=0.019). Also, CRP concentration significantly decreased after Pilates training in the experimental group (p=0.007) compared to the control group (p=0.534).Conclusion: The results indicated that Pilates training improves body composition, insulin resistance, and inflammatory parameters in middle-aged obese women.