BACKGROUND: Assess the effectiveness of traditional Chinese exercises in treating postmenopausal osteoporosis (PMOP) for evidence-based treatment support. METHODS: Design by March 2024, we conducted a thorough search across 8 databases for eligible randomized controlled trials (RCTs). Meta-analysis was conducted utilizing Stata 17.0 (StataCorp LLC, College Station) and interventions were ranked through a network meta-analysis approach. RESULTS: We analyzed 15 RCTs including 1018 patients with PMOP. Compared with the control group, the lumbar spine L2 to L4 bone mineral density (BMD) (mean difference (MD) 0.11 g/cm2, 95% confidence interval (CI) 0.05 to 0.17), clinical effectiveness (risk ratio 1.26, 95% CI 1.03 to 1.53), and Visual Analog Scale score (MD -0.78 points, 95% CI -1.48 to -0.09) showed a notable improvement in the traditional Chinese exercise group. The network meta-analysis results for the surface under the cumulative ranking curve (SUCRA) probability ranking showed that Ba Duanjin combined with conventional drugs (SUCRA 88.8%) had the most significant improvement in lumbar spine L2 to L4 BMD while Wu Qinxi combined with conventional drugs (SUCRA 87.8%) had the best effect on the reduction in Visual Analog Scale scores. CONCLUSIONS: Traditional Chinese exercises improve L2 to L4 BMD pain, bone turnover, and balance in PMOP. More extensive, high-quality RCTs are needed for validation.

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