<p>Osteoporosis is a common musculoskeletal disorder. Patients with this condition have poor treatment adherence. Health education may improve treatment adherence, nutritional self-care, and disease knowledge. In this study, a meta-analysis of randomized controlled trials was conducted to quantitatively evaluate the effects of health education on treatment adherence, dietary supplement use, and disease knowledge. This study was registered in PROSPERO (CRD420251089299). English literature from multiple databases was retrieved. Randomized controlled trials involving patients with osteoporosis were included. Two researchers independently extracted the data and evaluated the risk of bias via RoB2. Statistical analysis was conducted via R software. The effect size was measured as the RR or SMD. This study ultimately included 9 randomized controlled trials (10 articles). In terms of treatment adherence/antiresorptive drug use, health education tended to improve treatment adherence (RR [95% CI] = 1.14 [0.98, 1.33], <i>I</i>² = 68.4%), among which remote education based on electronic devices was statistically significant (RR [95% CI] = 1.09 [1.00, 1.18], <i>I</i>² = 12.1%); health education tended to improve the use of vitamin D supplements (RR [95% CI] = 1.16 [0.96, 1.41], <i>I</i>² = 67.8%); health education tended to improve the use of calcium supplements (RR [95% CI] = 1.09 [0.92, 1.30], <i>I</i>² = 52.2%); and health education tended to improve disease knowledge (SMD [95% CI] = 0.38 [− 0.08, 0.84], <i>I</i>² = 87.2%). This study highlights that health education tends to improve the adherence to the usage rate of anti-osteoporosis drug treatment, the usage rate of vitamin D and calcium supplements, and disease knowledge.</p>