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Purpose This study aimed to systematically evaluate the effects of Baduanjin exercise on mental health, sleep quality and fatigue among university students, explore the influence of intervention parameters on the outcomes, and assess the methodological quality of relevant randomized controlled trials (RCTs). In doing so, it addresses the current evidence gap regarding this non-pharmacological intervention, which remains fragmented despite the limitations of conventional mental health approaches. Methods Systematic searches were conducted in both English and Chinese databases to identify RCTs comparing Baduanjin intervention with routine care measures, covering all literature published up to January 15, 2026. Statistical analyses were performed using Review Manager 5.4 and Stata/SE 15.1, and subgroup analyses were conducted to explore how variations in intervention parameters influenced the measured outcomes. Results A total of 36 RCTs involving 3,233 university students were included in the systematic review, of which 35 studies with 2,846 participants were eligible for meta-analysis. Baduanjin practice significantly improved overall mental health (Symptom Checklist-90, SCL-90: 95% CI: −0.27 to −0.10, p 0.0001), alleviated depressive symptoms (Self-Rating Depression Scale, SDS: 95% CI: −5.67 to −3.00, p 0.0001), anxiety (Self-Rating Anxiety Scale, SAS: 95% CI: −6.30 to −1.73, p = 0.0006), reduced negative mood states (Profile of Mood States, POMS: 95% CI: −10.73 to −3.57, p 0.0001), perceived stress (Perceived Stress Scale/Chinese Perceived Stress Scale, PSS/CPSS: 95% CI: −0.77 to −0.08, p = 0.02), and fatigue (Fatigue Scale-14, FS-14: 95% CI: −1.55 to −0.46, p 0.0001), while enhancing sleep quality (Pittsburgh Sleep Quality Index, PSQI: 95% CI: −3.41 to −1.74, p 0.0001). Subgroup analyses suggested practicing Baduanjin three sessions per week may be most beneficial for general mental health (SCL-90), and a duration of 12 weeks or less may be more effective for reducing depressive symptoms (SDS) based on current evidence. Follow-up assessment indicated that improvements in sleep and stress were not sustained after intervention cessation. The overall methodological quality of included studies was moderate. Conclusion Regular Baduanjin practice effectively improves mental health, sleep quality, and subjective fatigue among university students. A frequency of a three-times-weekly schedule and a duration of up to 12 weeks appears to be associated with more favorable effects on selected outcomes. Given its low cost, ease of standardization, and scalability, Baduanjin may be considered as a potentially valuable complementary intervention for college mental health promotion. Future research should enhance methodological rigor to validate these findings and investigate the long-term maintenance mechanisms of therapeutic effects.
Chen et al. (Fri,) studied this question.