Background Fibromyalgia (FM) is a complex musculoskeletal disorder treated with multidisciplinary therapies. It is manifested by widespread musculoskeletal pain, functional disability, sleep disturbances and poor quality of life. Classical Indian Yoga is an ancient life style healing technique which has an integrated mind-body approach to enhance both physical and mental health, thus having a positive impact in treatment of FM. Objectives To study the role of Classical Indian Yoga as an integrated mind-body healing approach in the comprehensive treatment of fibromyalgia. Methods This study incorporated a 6 months, single-blind, randomized trial of Classical Indian Yoga (50 patients) versus attention control group (stretching and wellness education) of 50 patients for Fibromyalgia. The classical Yoga involved 60-minute group sessions thrice-weekly. The primary outcome measure was change in the FM Impact Questionnaire (FIQ) score at 1 year. Secondary outcome measures were tender point count, patient and physician global assessments, sleep quality (PSQI), 10-minute walk, timed chair stand, grip strength, depression and quality of life. These outcome measures were repeated at 1 year to test durability of response. Both groups were compared using an intent-to-treat analysis. Results Mean age of 100 patients was 55 years (SD 11), disease duration 10 years (SD 7) and BMI 30 kg/m2 (SD 8), 80 patients were females. Patients baseline expectations of benefit from an exercise intervention were similar: Classical Yoga =4.1 and the controls=4.3. After 6 months patients in the classical Yoga group had a significantly greater improvement in FIQ score: between-group change -20, 95% CI (-24.0 to -8.8); P=0.0005). The Yoga group patients also had significant improvement in secondary outcome measures: reduction in pain scale (VAS), improved patient global assessment, physical function, depression, and health status. After 1 year patients compliant with the classical Yoga had sustained and durable benefits in FIQ score quality of sleep and quality of life. The two groups did not differ in medication usage. No adverse events were noted. Conclusions Classical Indian Yoga appears to be highly effective in the management of FM having a positive impact on physical, psychological and social aspects of FM. Yoga can be used as a useful adjunctive treatment in the multidisciplinary treatment of this complex disorder. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.1020