Abstract Background This study aims to investigate the effect of Pilates exercises on sleep and fatigue among female college students residing in the dormitory. Methods This quasi-experimental study, two parallel groups was performed on 80 single female college students (40 per group), between 18 to 26 years old who lived in the two dormitories. One dormitory was considered as the intervention group and another as the control group. The Pilates group received three one-hour Pilates exercise sessions per week for eight weeks and the control group maintained their routine activities. The Pittsburgh Sleep Quality Index (PSQI) and the Multidimensional Fatigue Inventory (MFI-20) were used respectively to assess sleep quality and fatigue levels, at three time points: baseline, end of week four, and eight follow-ups. Fisher’s exact, Chi-square, independent sample t-test and repeated measurements were used. Results Overall, 66 participants completed the study (32 and 35 participants in the Pilates and control groups, respectively). After four and eight weeks of intervention, the overall mean score of sleep quality improved significantly (p