Purpose: This study was carded out to show the effects of Piates exercises (PE) and Connective Tissue Manipulation (CTM) on pain and depression in females with fibromyalgia (FM). Material and methods: Fifty-one women diagnosed as FM according to American College of Rheumatology criteda were included in this study. The subjects were divided into two groups, randomly; twenty seven FM subjects participated in a PE training program and 24 subjects were treated with CTM, three times a week for four weeks. Pain intensity was evaluated using visual analogue scale and depression predictors were assessed by Beck Depression Inventory. Results: Although the baseline scores of pain intensity and depression of the Pilates group were found to be worst compared to the CTM group, improvements were determined in both groups (p<0.05). At the end of the treatment period, no significant difference was found between the groups (p>00.5). Conclusion: The results of this study showed that these two approaches can be used to decrease pain intensity and depression symptoms in females with FM.