Background <p>Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent adverse effect linked to neurotoxic chemotherapeutic agents. Current pharmacological treatments exhibit limited efficacy and notable adverse effects. The clinical effectiveness of non-pharmacological therapies, like acupuncture, physical exercise (PE), cryotherapy (CR), and compression therapy, requires systematic comparison. This study employs a network meta-analysis (NMA) to appraise the efficacy and preventive effects of various non-pharmacological interventions on CIPN.</p> Methods <p>The study adhered to the PRISMA guidelines. Eight Chinese and English databases (up to October 2025) were searched. A fixed-effect NMA was executed using Bayesian methods to appraise the effects of interventions like acupuncture, CR, and PE on the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity questionnaire, the Numerical Rating Scale, the European Organization of Research and Treatment of Cancer Quality of Life Questionnaire-CIPN twenty-item scale, and the incidence of CIPN. Additionally, the risk of bias was appraised using the Cochrane tool.</p> Results <p>In total, 27 studies were included, comprising 2136 patients. The NMA indicated that, compared to medication, PE can effectively alleviate neurotoxicity (mean difference [MD]: − 9.9, 95% credible interval [CrI] [− 16, − 4.3]). Acupuncture exhibited superior efficacy in modulating peripheral nerve symptoms (MD: − 2.4, 95% CrI [− 3.8, − 1.1]), alleviating neuropathic pain (MD: − 1.1, 95% CrI [− 1.2, − 1.0]), and reducing the incidence of CIPN (MD: 0.23, 95% CrI [0.071, 0.52]).</p> Conclusion <p>PE can notably improve neurotoxicity. Acupuncture can alleviate clinical symptoms related to sensory and motor functions in CIPN. Additionally, it is effective in reducing neuropathic pain and might serve as a preventive measure against the onset of CIPN.</p>