Introduction Thoracic kyphosis is an abnormal upper spine curve, causing pain and posture issues. Pilates, focusing on core strength and flexibility, may help improve it. This review evaluates Pilates effectiveness in managing kyphosis. Methodology A review of studies from 2007 to 2023 was conducted using various academic databases, focusing on Pilates for thoracic kyphosis across different age groups. Results Fourteen studies showed Pilates improved spinal alignment, flexibility, and reduced pain, particularly in adults. Combining Pilates with other exercises was more effective, though results in children were minimal. Conclusion Pilates is beneficial for improving thoracic kyphosis, especially in adults. More research is needed to confirm its long-term effects.