Purpose <p>To examine dyadic intervention effects on family function, caregiver burden, and cancer patients’ symptom distress based on intervention features.</p> Methods <p>Six databases were searched from establishment until 31 March 2024. Two authors performed the search process, literature screening, and data extraction individually. The ROB version 2 and GRADE were used to check the methodology and evidence quality, respectively. The data were analyzed via RStudio, and intervention effects were estimated with 95% CIs and SMDs. The statistical heterogeneity was explored through the <i>I</i>² statistic and <i>P</i> values, and differences in overall effects were deemed statistically significant having the <i>P</i> value &lt; 0.05. Subgroup and sensitivity analyses were also conducted.</p> Results <p>Thirteen RCTs published from 2007 to 2021 with 1254 participants were included. The results demonstrated that dyadic interventions alleviated cancer patients’ symptom distress and family caregivers’ caregiver burden, and enhanced family function for the two parties. Subgroup analysis suggested that family-centered interventions in Asian countries enhanced family caregivers’ family function. Both the methodology and the degree of evidence were moderate.</p> Conclusions <p>Dyadic interventions effectively eased cancer patients’ symptom distress and family caregivers’ burden of care and improved family function. Family-centered dyadic interventions built in Asian countries also significantly enhanced family caregivers’ family function. Professionals and nurses should conduct culturally oriented dyadic interventions with advanced approaches to improve intervention effects and families’ overall health and optimize oncology nursing systems.</p> <p>Registration number: CRD42024556442</p>