The purpose of this study was to use the meta-analytic approach to examine the effects of aerobic exercise on resting systolic and diastolic blood pressure in women. Twenty-one studies representing 1029 subjects (663 exercise, 366 controls) and 54 primary outcomes (28 systolic, 26 diastolic) met the criteria for inclusion. Across all designs and categories, statistically significant decreases in resting systolic (mean +/- SD, -2.03 +/- 2.87, 95% confidence interval [CI] -3.14 to -0.92 mm Hg) but not diastolic (mean +/- SD, -0.64 +/- 2.02, 95% CI -1.45 to 0.18 mm Hg) blood pressure were found. Changes in resting systolic blood pressure were correlated with initial systolic blood pressure, initial body mass index, initial resting heart rate, and rest period before assessment of blood pressure. Meta-analysis of included studies suggests that aerobic exercise causes small reductions in resting systolic blood pressure in women. However, a need exists for additional, well-designed studies on this topic, especially among hypertensive adult women.