Introduction: Balance and postural impairments evolve directly out of stroke or from the core instability, leading to difficulty in activities of daily living. Literature has shown evidence that training the core muscles using the Pilates exercises has shown improvements in functional ability, balance and posture in normal, geriatric, multiple sclerosis and Parkinson__ampersandsignrsquo;s patients. Objective: To investigate the effects of clinical Pilates in balance, posture, and core stability of a recurrent lacunar stroke patient. Methods: The participant was a 59-year-old male with recurrent stroke along with uncontrolled hypertension and type 2 Diabe tes, came with Left hemiparesis, poor trunk control and reduced static and dynamic balance. Results: The 3 weeks of clinical Pilates along with conventional physiotherapy showed significant improvements in the Trunk Impairment Scale and Postural Assessment Scale for Stroke of a recurrent lacunar Stroke patient. Conclusion: Pilates is known as an exercise program to restore physical function effectively after stroke. Although, Pilates train ing has more beneficial effects on physical rehabilitation in stroke patients; the evidence to imply pilates exercises in the clinical practice is lacking in research.