Background <p>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. Music may help mitigate these challenges. This meta-analysis aimed to evaluate the effectiveness of music interventions across psychological, physiological, and academic outcomes in health sciences students.</p> Methods <p>A comprehensive literature search was conducted in nine databases up to August 2025, following PRISMA guidelines. Randomized controlled and controlled clinical trials comparing music interventions with control group were included. Meta-analyses were conducted using RevMan (version 5.4).</p> Results <p>Thirty-four studies (<i>n</i> = 2841) were included, mostly nursing (<i>n</i> = 24), medical (<i>n</i> = 7), dental (<i>n</i> = 2), and midwifery (<i>n</i> = 1) students. Meta-analyses demonstrated significant reductions in anxiety (SMD = − 0.48, 95% CI [− 0.72, − 0.23]; <i>p</i> = 0.001), depression (SMD = − 1.00, 95% CI [− 1.95, − 0.04]; <i>p</i> = 0.040), and vital signs, including systolic blood pressure (MD = − 7.15, 95% CI [− 9.64, − 4.66]; <i>p</i> &lt; 0.001), diastolic blood pressure (MD = − 3.72, 95% CI [− 5.53, − 1.91]; <i>p</i> = 0.050), and pulse rate (MD = − 3.77, 95% CI [− 7.46, − 0.07]; <i>p</i> = 0.050). No significant effects were found for stress, self-efficacy, sleep quality, pain, or academic performance.</p> Conclusion <p>Music interventions effectively improve emotional well-being and autonomic regulation among health sciences students. Although their effects on academic or behavioral outcomes remain inconclusive, music represents a simple and safe approach to enhance psychological resilience in educational environments.</p> Trial registration <p>International Prospective Register of Systematic Reviews (PROSPERO) (CRD420251150104).</p>