ObjectiveTo systematically review the effect of Schroth therapy on adolescent idiopathic scoliosis. MethodsThe PubMed, Ebsco, Embase, Cochrane Library, Web of Science, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) related to the objects from inception to November 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 14 RCTs involving 589 patients were included. The results of meta-analysis showed that Schroth therapy significantly reduced patients' Cobb angle (MD=−3.21, 95%CI −3.87 to −2.55, P<0.01) and angle of trunk rotation (ATR) (MD=−2.39, 95%CI −3.07 to −1.71, P<0.01), and improved SRS-22 quality of life score (MD=0.16, 95%CI 0.01 to 0.30, P=0.04) compared with the control group. Subgroup analysis results showed that Schroth therapy had a better effect on improving the quality of life in moderate patients. Schroth therapy for 1.5-3 months, 5-7 times therapy a week, and a single 30 minute and 40-60 minutes therapy showed better improvement in patients' quality of life. Conclusion Current evidence shows that Schroth therapy can effectively improve Cobb angle, ATR, and quality of life in adolescents with idiopathic scoliosis. The improvement effect on quality of life is influenced by the intervention period, frequency, and duration of each intervention.