Abstract Background: The Pilates method is a conditioning program in hypertensive patients of the body and mind that is gaining in popularity and acceptance worldwide. Aim of Study: To determine the response of kidney func-tions after pilates exercise in patients with hypertension. Material and Methods: Fifty Patients of both sexes were recruited from El-Santa Central Hospital, their ages ranged from 40 to 50 years. All of them suffered from hypertension form 5-10 years ago moderate stage systolic (160-179mmHg) diastolic (100-109mmHg) to severe stage systolic (180-209 mmHg) diastolic (110- 1 19mmHg) according to Joint National Committee (JNC-V) classification. The study was pre-post study, were all the patients performed 5 pilates exercises per session for 3 sessions per week for a whole study duration of 8 weeks we measure kidney function tests (urea-creatinine) and blood pressure (systolic and diastolic). Results: The statistical analysis by paired t-test revealed that there was significant difference (p=0.00 1; p < 0.05) between pre- and post-systolic blood pressure within study group, the mean values of pre- and post-diastolic blood pressure were 100±8.32 and 95±8.02, respectively, with improvement per-centage 5.00%. The statistical analysis by paired t-test revealed that there was significant difference (p=0.00 1; p < 0.05) between pre- and post-diastolic blood pressure within study group, the mean values of pre- and post-creatinine were 1.76±1.12 and 1.69±1.10, respectively, with improvement percentage 3.98%. The statistical analysis by paired t-test revealed that there was no significant difference (p=0.083; p>0.05) between pre- and post-creatinine within study group, The mean values of pre-and post-urea were 61.09±6.40 and 58.93±6.31, respectively, with improvement percentage 3.54%. The statistical analysis by paired t-test revealed that there was no significant difference (p=0.068; p>0.05) between pre- and post-urea within study group. Conclusion: Pilates exercises have a statistically significant effect on blood pressure but not on kidney functions in patients with hypertension.