Background: With the aid of the DASH diet, which is used to lower blood pressure, Pilates exercise helps to improve cardiometabolic risk factors in women with metabolic syndrome. Aim of the study: This study was conducted to determine how Pilates workouts affected the cardiometabolic risk variables in female patients with metabolic syndrome. Materials and Methods: 60 obese adult women, aged 45 to 55, who were randomly chosen from Elkalioubia governorate's outpatient internal medicine clinics, took part in the study. The internal medicine doctor recommended these. They were divided into two equal groups at random. Group A, which included 30 subjects, got DASH diet, three sessions of 60 minutes each, three sets per session of pilates exercise, and medical care for twelve weeks. Group B, which included 30 patients, got DASH diet and medical care for a total of twelve weeks. Blood analysis was measured before and after 12 weeks of training for (fasting blood sugar, post-prandial blood sugar, glycosylated hemoglobin, total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides) and Borg scale.