Cardiorespiratory fitness (CRF) is established as a clinical vital sign in therapeutic strategy to restoring health of patients in medical conditions inclusive of age-related diseases. The beneficial effects of Pilates training (PT) are recognized for various aspects of health and fitness, but limited data present an impact on cardiorespiratory fitness. Thus, the current narrative review discusses the impact of the PT interventions on indicators of cardiorespiratory function among different patient groups to identify the mechanisms linking CRF with PT. The authors searched systematically databases: PubMed, Web of Science from inception to March 2023 and analyzed available data including finally 20 papers. In description of the findings PEDro Scale and final score was used. Analyzed data indicated: a) pleiotropic input of PT on improving physical performance in medical conditions; b) specific parameters characterizing effectiveness of PT in each group of patients according of disease; c) different range of static significance and effect size especially for such following indicators as: VO2 at VT (ml•kg-1•min-1), VO2 peak/max (ml•kg-1•min-1), HR at VT (beats•min-1), HRmax (beats•min-1), VE (L•min-1). We also formulate and discuss potential physiological mechanisms of PT affecting CRF. This paper showed PT: a) has positive impact on broad spectrum of indicators of cardiorespiratory function by pleiotropic action among different patients' groups; b) significant ameliorates quality of life that may contribute to long-standing behavior change of patients related with overall physical activity.