Background: Urinary incontinence (UI) is clinically defined by the International Continence Society as involuntary urine loss. Currently, UI isconsidered a public health issue worldwide, considering that the prevalence in women is quite high, requiring attention from healthprofessionals. Objective: To evaluate the effects of the Pilates method associated with Manual Therapy in women with UI. Methods: It wasperformed a randomized, controlled, longitudinal clinical trial with a quantitative approach of the data. 14 female participants were evaluated,aged 20 to 55 years and who had presented episodes of urinary loss in the last months. The following evaluations were carried out: anamnesis,evaluation of urogynecological history, application of the King’s Health Questionnaire and PERFECT test. After all the evaluations, half of thevolunteers received treatment for urinary incontinence through a physical therapy approach that includes the Pilates method associated withManual Therapies (GPT), and the other half received treatment using only the Pilates method (GP). Results: Both groups showed increasedPFM strength, being GPT (p = 0.04) and GP (p = 0.00); increased resistance, being GPT (p = 0.02) and GP (p = 0.01); and the contraction offibers, being GPT (p = 0.04) and GP (p = 0.02). In the GPT there was a decrease in the severity measures (p = 0.01); disappearance ofnocturia (p = 0.04); decreased symptoms of SUI (p = 0.02); and bladder pain (p = 0.04). In the GP, there was a significant improvement in theperception of health (p = 0.00); decreased UI impact on the participant's life (p = 0.02); the influence of UI on emotions (p = 0.00); symptomsof overactive bladder (p = 0.01); and the SUI (p = 0.00). Conclusion: Both treatment protocols decrease episodes of leakage of urine whenthere is an increase in intra-abdominal pressure, increase the PFM strength, endurance and number of fast contractions, and the quality oflife of women with UI. However, only the group that received only the Pilates protocol showed an increase in repetitions of slow contraction.