Music has accompanied humans even before the written word. Its use to alleviate pain is present in most cultures. Studying music-induced analgesia requires categorization and standardization of music as much as possible in the interest of increased reliability of efficacy. Herein, we present an ample systematic review and meta-analysis of 120 clinical trials exploring the efficacy of music in the management of pain in a combined total of 9660 individuals exposed to music and 9798 controls. We also explored the effects of demographic variables, pain etiology, and chronicity, as well as music intervention characteristics. We analyzed data using a random-effects model with standardized mean differences; meta-regression was used to assess the impact on effect size and heterogeneity (expressed in terms of I-square statistic). We found music has a moderate analgesic effect, with duration of intervention being the strongest predictor of music-induced analgesia. Current music interventions are highly heterogeneous. Slow, no-percussion, instrumental music might represent the type of music most reliably associated with analgesia though evidence is insufficient to assess its superiority. Providing details on the objective properties of the music intervention will improve music therapy research in the future.