Objective <p>The aim of this meta-analysis was to evaluate the impact of gonadotropin-releasing hormone analog (GnRHa) treatment on height outcomes in girls aged over 6 years with central precocious puberty (CPP).</p> Methods <p>A systematic search was performed across PubMed, Cochrane Library, Web of Science, MEDLINE, EMBASE, CNKI, and Wan Fang databases to identify eligible studies. The meta-analysis protocol was registered at PROSPERO, and the quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was used to synthesize data on height gain, final adult height (FAH), FAH standard deviation score (SDS), bone age, and the difference between FAH and target height (TH).</p> Results <p>Fifteen studies including 1270 girls were identified. The results indicated that GnRHa therapy significantly improves height outcomes in girls with CPP aged over 6 years. By effectively delaying pubertal progression and bone age maturation, GnRHa treatment enables these girls to achieve a greater FAH and potentially surpass their TH. Meta-analysis showed that the GnRHa treatment group demonstrated significantly greater height gain (WMD = 2.52, 95% CI [1.66, 3.37]), FAH (WMD = (WMD = 3.18, 95% CI [1.49, 4.87]), and FAH minus TH (WMD = 0.61, 95% CI [0.42, 0.79]) compared to the control group. Additionally, bone age (WMD = −1.02, 95%CI [−1.99, −0.06]) was significantly lower than the control group. However, FAH SDS showed no significant difference between the groups (WMD = 0.09, 95%CI [−0.40, 0.58]).</p> Conclusions <p>GnRHa treatment demonstrates substantial benefits in promoting height outcomes in girls over 6 years old with CPP. This meta-analysis contributes to the growing body of evidence supporting the efficacy of GnRHa in managing CPP and underscores the importance of early intervention to maximize height potential in affected individuals.</p>