Objective <p>This meta-analysis evaluated the effects of complementary and alternative therapies on menopausal symptoms.</p> Materials and methods <p>Relevant randomized controlled trials published after 2020 were systematically searched in the ASSIA, CENTRAL, CINAHL, LILACS, PubMed, Embase, and WOS databases. A total of 24 studies were included, and analyses were conducted using RevMan and JASP software. Heterogeneity and publication bias were assessed using various statistical methods. Results&#xa0;Twenty-four randomized controlled trials were synthesized. Evidence from the included studies indicates that complementary and traditional interventions may contribute to improvements in menopausal symptoms; however, effect estimates varied substantially across studies. A random-effects meta-analysis identified an average effect estimate, but substantial heterogeneity (τ² = 0.362) and a wide 95% prediction interval (−0.228 to 2.340) suggest considerable uncertainty in the magnitude and direction of effects across different settings. Meta-regression analyses showed that larger sample sizes were associated with smaller observed effects (β = −0.005, p = .014), indicating potential small-study effects. Intervention duration significantly influenced outcomes, whereas intervention type, dose, and formulation were not significant moderators. Subgroup analyses suggested beneficial trends for both herbal and non-herbal interventions, although prediction intervals remained wide, reinforcing the variability of findings.</p> Conclusion <p>Improvements were most consistent for hot flashes, while evidence for overall symptom severity and quality of life was less consistent. Although no statistically significant publication bias was detected, this finding should be interpreted with caution given the limited number of studies and observed heterogeneity. Integrating evidence-based complementary and alternative approaches into clinical guidelines could enhance holistic women’s healthcare.</p>