© 2020 Elsevier Ltd Background: Evidence supports positive effects of exercise on mental health outcomes among people with Multiple Sclerosis (PwMS). However, non-traditional exercise modes like Pilates remain understudied. Objective: This study will investigate the effects of an eight-week immediate start home-based Pilates compared to delayed-start control condition on symptoms of anxiety, depression, and fatigue among PwMS. Methods: 68 adults (>18 years old) with physician diagnosed Multiple Sclerosis, Patient Determined Disease Steps (PDDS) score <3, who are free from any other significant physical or psychiatric condition, with no previous Pilates experience, and who have no medical contraindications to safe participation in physical activity, will be randomised to two weekly home-based Pilates sessions guided by a DVD, or wait-list control. Empirically validated measures will assess symptoms of anxiety, depression, and fatigue at baseline, and weeks two, four, six and eight of the intervention. Standardized mean differences and Hedges' d will be calculated to explore magnitude of change in response to home-based Pilates compared to delayed-start control condition. Based on recent feasibility findings, we hypothesize that, compared to wait-list control, immediate-start home-based Pilates will result in moderate-to-large improvements across outcomes. Conclusion: This randomised controlled trial will provide additional information regarding the feasibility of Pilates to improve mental health outcomes, and the magnitude of the effects of Pilates compared to a wait-list control on mental health outcomes among PwMS. These findings should inform both healthcare professionals and exercise scientists regarding the potential of home-based Pilates to improve management of several mental health symptoms prevalent among PwMS.