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We aimed to evaluate the effects of resistance training with and without pelvic floor muscle (PFM) contraction on pelvic floor morphology and muscle function in older women. Seventeen older women without pelvic floor disorders participated in this clinical feasibility trial. The women were divided into three groups: resistance training without PFM contraction (RT); resistance training with simultaneous PFM contraction (RT+PFMC); and control. Maximum voluntary contraction (MVC) and the endurance of PFM contraction were measured by perineometer, and bladder neck angle and Hiatal area by translabial ultrasound. As an acute effect, MVC increased in the RT group (effect size r = −0.51). After 12 weeks, worsening was observed in the duration of contraction in RT (effect size r = −0.55) and RT+PFMC (effect size r = −0.52). Bladder neck angle improved in the RT+PFMC group (effect size r = −0.51). Resistance training acutely improves MVC and chronically worsens the duration of contraction. Resistance training with simultaneous PFM contraction improves the bladder neck angle after 12 weeks.