Aim: To synthesise the effect of aromatherapy on fatigue in adults receiving haemodialysis treatment in randomised controlled trials. Design: A systematic review and meta-analysis of randomised controlled trials following the Cochrane methods. Data resources: Systematic search was carried out using the Cochrane Library, CINAHL, Council of Higher Education National Thesis Center, Networked Digital Library of Theses & Dissertations, Science Direct, Springer Link, Scopus, PubMed, ProQuest, Ovid, ULAKBIM Turkish National Databases and Web of Science without year limitation for studies published in the English language. The review covered the period between 1960 and April 2020. Review methods: Three authors reviewed the risk of bias independently and systematically using the Cochrane Collaboration tool. Results: Eight studies with 606 participants were included in this systematic review and meta-analysis. Aromatherapy was applied through inhalation and massage methods and performed from 2 to 30 min and in 3 to 30 sessions. There was no significant publication bias. Aromatherapy had a large effect on fatigue in adults receiving haemodialysis treatment and high heterogeneity. Conclusion: Aromatherapy has a high and positive effect on fatigue in the adults receiving haemodialysis and can be used as an effective intervention in the management of fatigue. Impact: Aromatherapy may help to reduce the severity of fatigue in adults receiving haemodialysis. The findings of this systematic review and meta-analysis will contribute to the use of aromatherapy in the management of fatigue and conduction of randomised controlled trials related to aromatherapy.