Purpose: The study compared the efficacy of hydrotherapy and land-based exercises in the management of chronic low back pain (CLBP). Methods: Twelve patients diagnosed with CLBP were randomly assigned into either hydrotherapy or land-based exercise groups. Similar exercises were prescribed for both groups throughout the 6-week program. The treatment outcome measures were Visual Analog Scale (VAS), Modified Schober Flexion Technique (MSFT) and Modified Schober Extension Technique (MSET). Participants were assessed at baseline and after six weeks by an independent assessor. Paired t-test was used to compare within group scores whilst between-group comparison of post-treatment outcomes was analyzed using unpaired t-test. Alpha level was set at p < 0:05. Results: The mean (standard deviation) duration of symptoms for land-based and hydrotherapy groups were 48.5 (37.39) months and 66.0 (48.45) months, respectively. There were significant differences ( p < 0:05) between the pre-treatment and post-treatment VAS, MSFT and MSET for the hydrotherapy groups. Whilst the VAS and MSET scores were significantly different ( p < 0:05) from baseline scores in land group, the MSET failed to show any significant difference. Comparison of both groups showed hydrotherapy group scoring significantly higher ( p < 0:05) only on MSFT than land group. Conclusion: The two exercise media were relevant in the management of CLBP, though hydrotherapy seems to be better for spinal flexibility, thus serving as a better alternative in clinical practice.