Background <p>Premenstrual syndrome (PMS) has a wide variety of signs and symptoms, including physical, psychological, and behavioral Symptoms of sufficient severity to interfere with daily activities.</p> Objective <p>The study aimed to compare the effectiveness of a Tele-Pilates intervention and Kinesio Taping in managing symptoms of premenstrual syndrome (PMS).</p> Methods <p>Ninety female participants aged 18 to 25 diagnosed with PMS were randomly assigned to one of three groups: the Kinesio taping group (KT), the Tele-Pilates exercise group (TP), or the Control group (CG). The KT group received taping intervention for eight weeks, the TP group engaged in an eight-week Tele-Pilates exercise program, while the CG maintained their usual routines without intervention. The Premenstrual Syndrome Questionnaire (PMSQ) was administered to all groups at baseline and again after eight weeks of intervention to assess premenstrual symptoms.</p> Results <p>Pairwise comparisons revealed significant reductions (p = 0.001) in all subdimension scores of PMSQ in both the KT and TP groups following the intervention. The control group did not show any statistically significant improvements (PMS-A: p = 0.078; PMS-C: p = 0.066; PMS-D: p = 0.333; PMS-H: p = 0.344; other symptoms: p = 0.290; cramps: p = 0.349; backache: p = 0.415). Post hoc analysis revealed no significant difference between the KT and TP groups in the degree of symptom reduction after treatment.</p> Conclusions <p>Tele-Pilates and Kinesio taping interventions demonstrated similar effectiveness in reducing PMS symptoms, with no significant differences in outcomes between the two.</p> Trial registration <p>Clinicaltrials.gov, NCT07063472. Registered 2 July 2025—retrospectively registered.</p>