Background <p>Nursing and health sciences education involves intensive theoretical and clinical training that can expose students to psychological and physiological stressors, potentially affecting their well-being and academic success. Aromatherapy may help mitigate these challenges. The aim of this meta-analysis was to evaluate the effectiveness of aromatherapy interventions across psychological, physiological, and academic outcomes in nursing and health sciences students.</p> Methods <p>A comprehensive search was conducted between 24 and 31 August 2025 across nine databases. Randomized controlled and controlled clinical trials comparing aromatherapy with control or placebo groups were included. Data extraction was performed independently by two reviewers, and risk of bias was assessed using the Cochrane RoB tool. Meta-analyses were conducted using RevMan (version 5.4).</p> Results <p>Thirty-three studies involving 2.312 participants were included. Aromatherapy significantly reduced anxiety (SMD = − 0.46, 95% CI [–0.63, − 0.30], <i>p</i> &lt; 0.00001), pain (SMD = − 1.29, 95% CI [–1.70, − 0.88], <i>p</i> &lt; 0.00001), fatigue (SMD = − 0.79, 95% CI [–1.52, − 0.07], <i>p</i> = 0.03), and systolic (MD = − 3.72, 95% CI [–6.78, − 0.67], <i>p</i> = 0.02) and diastolic blood pressure (MD = − 2.30, 95% CI [–3.67, − 0.92], <i>p</i> = 0.001). No significant effects were observed for stress, pulse rate, respiratory rate, or academic performance.</p> Conclusion <p>Aromatherapy appears to be a safe and promising complementary intervention for improving psychological well-being and physiological regulation in nursing and health sciences students. Further high-quality research is needed to refine intervention protocols and strengthen evidence for its educational applications.</p> Trial registration <p>International Prospective Register of Systematic Reviews (PROSPERO) (CRD420251150078).</p>