Breast cancer-related lymphoedema (BCRL) is a common sequela of surgical or radiation therapy of breast cancer. Although being an important part of conservative therapy, the role of manual lymphatic drainage (MLD) on BCRL is still debating. The objective of the current systematic review and meta-analysis was to determine whether the addition of MLD to the standard therapy (ST) could manage BCRL more effectively. We searched PubMed, EMBASE and Cochrane Library for related randomised clinical trials to compare the volume reduction, improvement of symptoms and arm function between groups with or without MLD. Four randomised controlled trials, with 234 patients, were included. Results showed there was a significant difference in volume reduction between MLD plus routine treatment and sole routine treatment. Current trials show that adding MLD to the ST could enhance the effectiveness of treating volume reduction of lymphoedema, but might not improve subjective symptoms or arm function.