Introduction Essential hypertension is a common disease that could result in various health problems and remains a major threat to public health. This systematic review and meta-analysis was performed to examine the therapeutic effects of Tai chi on adults with essential hypertension in China. Method Four English databases and three Chinese databases were searched for randomized controlled trials (RCTs) from the earliest data available to October 31 st 2016. Methodological quality was evaluated and a meta-analysis was also performed. Results Twenty trials met the eligibility criteria showed that Tai chi exerted favorable effects on the systolic blood pressure (SBP), diastolic blood pressure (DBP) [SMD = −0.84, 95% CI (−1.18, −0.50)], body mass index [SMD = −0.39, 95% CI (−0.73, −0.06)], waist circumference [SMD = −0.53, 95% CI (−0.74, −0.32)], nitric oxide (NO) content and quality of life of participants compared with no-treatment. Compared with antihypertensive drugs, Tai chi showed favorable effects on SBP, DBP, NO and quality of life of hypertensive patients. Compared with wellness education and walking, Tai chi also showed a reduction on blood pressure. Conclusion Although some of the RCTs suggested that Tai chi can be useful in the management of hypertension, further rigorous studies would be required to look into the potential of Tai chi as preventative measure and method of management of hypertension in China.