Background and Purpose: Decreased bone mineral density (BMD) is a common condition in postmenopausal women that can be managed with impact activities. Among the activities studied are the whole-body vibration (WBV) and musclestrengthening exercises. The purpose of this study was to compare the effects of WBV versus Pilates exercise on BMD in postmenopausal women. Methods: In this study, 51 postmenopausal women were randomized into 3 groups: vibration (n = 17), Pilates (n = 17), and control (n = 17). Outcomes were the areal bone mineral density (aBMD) (lumbar spine, femoral neck, total hip, trochanter, intertrochanter, and ward's area) assessed by dual-energy x-ray absorptiometry at baseline and followup. The interventions were performed 3 times a week for 6 months, totaling 78 sessions. The analysis was performed with intention-to-treat and covariance analyses adjusted for baseline outcomes. Results: After 6 months, 96.1% of the participants completed the follow-up. The analyses demonstrated signifi cant mean between-group differences in favor of the interventions: vibration versus control, for the aBMD of the lumbar spine (0.014 g/cm 2; 95% confi dence interval [CI], 0.006-0.022; P =.018, d = 1.21) and trochanter (0.018 g/cm 2; 95% CI, 0.006-0.030; P =.012, d = 1.03); and Pilates versus control, for the aBMD of the lumbar spine (0.016 g/cm 2; 95% CI, 0.007-0.025; P =.008, d = 1.15) and trochanter (0.020 g/cm 2; 95% CI, 0.010-0.031; P =.005, d = 1.28). Conclusion: In postmenopausal women, 3 weekly sessions of WBV or Pilates administered for 6 months provided an equal effect on BMD.