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Purpose: Pilates has become popular among patients as well as the general public as a way of strengthening the core. Core-strengthening exercises affect spinal stabilization, resulting in a change in body alignment, but there is limited research on this. Therefore, the present study aimed to investigate the effects of a pilates core exercise program on the sagittal and forehead body alignment of 20 adult female participants with abnormal body alignment. Methods: participants completed a six-part pilates core exercise program for 60 minutes a day three times a week for a total of 16 weeks that included: 1) hundreds, 2) roll-up and -down, 3) leg circle, 4) breaststroke prep, 5) leg pull front with push-up plus position, and 6) half roll back. Results: When the body alignment was measured for the front, back, and side of the body using an exbody® analyzer to compare the results before versus after the intervention using the paired t-test, the measurements became closer to the ideal body alignment on the forehead and sagittal plane (p < 0.05), while the difference in left–right symmetry was also significantly reduced (p < 0.05). Conclusion: In conclusion, we confirmed here that the pilates core exercise has a positive effect on body alignment.