Background and Aim: Aging is associated with muscle weakness and decreased physical abilities. Resistance training has been introduced as an effective method to improve physical performance. Considering the varying results of previous studies regarding the effects of this type of exercise on metabolic diseases, particularly in older adults with diabetes, the present study aimed to investigate the effects of 12 weeks of resistance training with Pilates band on liver enzymes Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP), body composition, and leg muscle strength in elderly women with type II diabetes. Materials and Methods: In this study, 26 elderly diabetic women (aged 65–80 years) were randomly assigned to an exercise group (n=13) and a control group (n=13). The exercise group performed resistance training with pilates elastic band for 12 weeks, three sessions per week, while the control group received no intervention. Liver enzymes, body composition, and leg muscle strength were evaluated before and after the intervention. Data were analyzed using Analysis of Covariance (ANCOVA) at a significance level of p<0.05. Results: the ANCOVA showed significant between-group differences in body weight (p=0.004), BMI (p=0.0001), and leg muscle strength (p=0.004), but no significant difference in fat mass (p=0.16). On the other hand, no significant differences were observed for liver enzymes between-group (AST p=0.75, ALT p=0.69, ALP p=0.81). Conclusion: Although resistance training with Pilates bands did not have a direct effect on liver enzymes, it significantly improved body composition and muscle strength, which may positively influence liver health in elderly women with type 2 diabetes over the long term.