© 2017 Elsevier GmbH Introduction Fear of falling is a major problem facing the health care system. No clear evidence exists as to the most effective management approach although a need for both psychological and physical intervention is recognised. The Alexander Technique (AT) is primarily an educational holistic self-management approach which improves balance and has psychological benefits. This small scale mixed methods exploratory pilot study investigated changes following, and acceptability of, an AT group intervention for older people with a fear of falling. Methods Twelve volunteers aged ≥ 65 years with a fear of falling took part in a nine-week, 12 session AT group intervention. They completed a range of standardised measures at 4 time points (baseline, immediately pre and post intervention, and one month post intervention). A sub-group participated in a focus group discussion following the group intervention. Quantitative data were analysed using non-parametric statistics, with thematic analysis employed for qualitative data. Results The fear of falling primary outcome measure and other quantitative results were inconclusive, however focus group qualitative data suggested some profound changes with improvements in movement, mood and confidence. A combination of awareness and acceptance led participants to feel empowered to make adjustments to their activity. Participants found learning the AT enjoyable and were able to use it to advantage in everyday activities. Conclusions The intervention had a positive impact on falls-related and physical skills, and psychological well-being. This supports its potential as a useful intervention for older people with a fear of falling, larger scale studies are merited.