To compare the effects of aerobic training versus aerobic training combined with clinical Pilates exercises (CPE) on the functional and psychosocial status of patients with ankylosing spondylitis (AS). Twenty-eight patients with ankylosing spondylitis (AS) were randomized into 2 groups. Group 1 (n = 14) performed both aerobic training and CPE, whereas group 2 (n = 14) performed aerobic training alone. Functional status of the patients was assessed using the Bath Ankylosing Mobility Index (BASMI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), back scratch test (BST), single leg stance test, functional reach test, a dynamometer, chair sit and stand test, and 6-minute walk test (6MWT), and the psychosocial status of the patients was assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, the Multidimensional Assessment of Fatigue (MAF), Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety Depression Scale (HADS), and Tampa Scale of Kinesiophobia (TSK). Both training programs were conducted for 8 weeks, and then, the assessments were repeated. A statistically significant improvement was observed in the BASMI ( = .001), BASDAI ( = .001), BASFI ( = .002), BST (right, = .05; left, = .025), functional reach test ( = .013), back muscle strength ( = .033), 6MWT ( = .011), ASQoL ( < .001), MAF ( = .01), and PSQI ( = .013) scores in group 1. A significant difference was observed in the BASDAI ( = .028), chair sit and stand test ( = .022), 6MWT ( = .04), and ASQoL ( = .04) scores in group 2. CPE in addition to aerobic training was more effective in improving the functional and psychosocial status of the patients with AS.