Introduction: Recommendations for Type 2 Diabetes (T2D) prevention promote lifestyle behaviour changes in diet and exercise (traditionally aerobic). In the 2012 guidelines for pre-diabetes, Exercise and Sports Science Australia (among other International organisations) has endorsed resistance training (in combination with aerobic activity). We conducted a systematic review and meta-analysis of multi-component lifestyle T2D prevention studies which included diet + aerobic exercise + resistance training and assessed their characteristics and effectiveness. Methods: Eight electronic databases were searched up to January 2012. Studies were eligible if they: 1) recruited pre-diabetic or individuals at risk of T2D; 2) conducted diet and exercise [both aerobic and resistance training] programs; 3) reported impact on body weight and plasma glucose. Results: In total, 23 articles from eight studies were eligible including five randomised controlled trials, one quasiexperimental, one two-group comparison and one single-group pre-post study. Median intervention length was 12 months (range 4-48 months). In general participants were advised to lose weight (7-10%), achieve a target macronutrient distribution, perform aerobic exercise for an average frequency of 5.0±1.5 days/week, with an average weekly duration of 157.5±44.4 min, and perform RT for an average of 2.3±0.7 days/week for an average total duration of 90.0±24.5 min. Four articles had a low risk of bias (score ≥6/10). Meta-analysis favoured interventions over controls for weight loss (-3.79 kg [-6.13, -1.46; 95% CI], Z = 3.19, P = 0.001) and fasting plasma glucose (-0.13 mmol.L-1 [-0.24, -0.02; 95% CI], Z = 2.42, P = 0.02). Aerobic exercise tests to measure/predict VO2max (fitness) were reported in five studies, and improvements were observed in all intervention groups. No studies used objective measures to assess physical activity, which is a major limitation. It is noteworthy that only one study measured changes in muscular fitness. Discussion: Multicomponent lifestyle programs for prevention of T2D are effective in eliciting moderate weight loss and small improvements in glycaemic control. Indications of impact on aerobic fitness were commonly reported, however impact on muscular fitness was generally not reported. The lack of studies evaluating muscular fitness makes it impossible to determine whether the addition of resistance training to other lifestyle interventions is beneficial for improvements in muscular fitness or glycaemic control. Future multicomponent T2D prevention studies should provide comprehensive and objective evaluation of effects on aerobic and muscular fitness.