Introduction Mechanical neck pain is a common problem in the world today and there are epidemiological and statistical studies documenting the high incidence and prevalence of mechanical neck pain, which effects people's daily function [1]. Nearly 50% of the population suffer from neck pain at least once in their life [2,3], prevalence is high in middle age, with women being affected more than men [3-5] the prevalence of neck pain varies widely between studies, with a mean point prevalence of 7.6% (range 5.9-38.7%) and mean lifetime prevalence of 48.5% (range 12.2-71.0) [6]. The etiology of uncomplicated neck pain is unclear. Most uncomplicated neck pain is insidiously and is generally multifactorial in origin associated with poor posture, anxiety, depression, neck strain, occupational activities and sporting injuries [4,7]. Chronic mechanical neck pain is characterized by pain in cervical region with restricted range of motion and dysfunctional musculature [1]. Reduction of activation of deep cervical flexor muscles (longus coli and longus capitis) is one of the most important factor in mechanical neck pain, superficial neck muscles (sternocleidomastoid and anterior scalene) become over active and painful. Generally, the physiotherapy methods for mechanical neck pain consist of stretching and strengthening the neck muscles [8] cervical stabilization exercises, cervical mobilization exercises, thoracic thrust manipulation, ischemic compression on trigger points [7-10], kinesio-taping method [2,3] and electrotherapy [11]. Joseph H. Pilates developed the comprehensive program known as the Pilates method in the 1920's [12]. Pilates is another popular form of mind-body exercises where the focus is on controlled movement, posture and breathing. It is system designed to condition the body as well as improve posture, muscle tone, alignment and provide flexibility by using exercises that stretch and strengthen selective muscles [1,13]. Very few studies have shown the effectiveness of Pilates in treating chronic mechanical neck pain. Pilates exercises were used to strengthen and stabilize the neck muscles. The key is to strength the inner (local) muscles of the neck and ensure the large outer (global) muscles are not being used to support your head [12,14]. However, there are no studies which compared the effectiveness of Pilates combined with conventional therapy alone. Methods and Study Design We recruited 60 subjects from Physiotherapy outpatient Department, Nizam's Institute of Medical Sciences, Hyderabad. Subjects diagnosed with chronic mechanical neck pain by Orthopedic department were included in the study. Abstract Background: Neck pain is one of the most common musculoskeletal disorders second to low back pain associated with chronic pain, restricted range of motion and muscular imbalance. Generally, the physiotherapy methods for mechanical neck pain consist of stretching and strengthening the neck muscles, cervical stabilization exercises, cervical mobilization exercises, thoracic thrust manipulation, ischemic ...