Background <p>Pelvic organ prolapse (POP) substantially affects women’s health and quality of life. Pelvic floor muscle training (PFMT) is a promising conservative treatment for POP, but evidence from randomized controlled trials (RCTs) remains diversity. This systematic review and meta-analysis aimed to evaluate the effectiveness of PFMT for POP.</p> Methods <p>We conducted a systematic review by using the PICOS framework, including RCTs that aimed to compare PFMT with other conservative treatments for POP. Outcomes included POP Symptom Score (POP-SS), POP Quantification (POP-Q), self-reported symptom improvement, and pelvic floor muscle function (sEMG-MVC, endurance, Modified Oxford Grading).</p> Results <p>A total of 16 studies were included in this meta-analysis. Compared with the control group, PFMT group was associated with lower POP-SS, higher sEMG-MVC, and greater pelvic floor muscle endurance. PFMT also improved self-reported symptom improvement, overall POP-Q stage, and anterior vaginal wall prolapse. No clear benefit was seen for posterior vaginal wall prolapse or Oxford grade. Short-term PFMT (≤ 6 months) showed beneficial effects, whereas long-term efficacy (&gt; 6 months) and effects in individuals aged ≥ 55 years were not statistically significant.</p> Conclusions <p>PFMT may improve short-term symptoms and pelvic floor muscle function in women with POP. However, long-term efficacy and effects in older women remain uncertain and require further investigation.</p> Trial registration <p>Not applicable.</p>