Abstract Background: We aimed to evaluate the effect of music-based intervention on the aggressive behavior in children and adolescents, and made a comparison of music medicine and music therapy. Methods: We searched PubMed (MEDLINE), Ovid-Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify relevant studies. Standardized mean differences (SMDs) were estimated with random-effect model. Results: We included 10 studies and found a significant decrease of aggressive behavior (SMD =
0.99; 95% CI =
1.42 to
0.56) and a significant increase of self-control (SMD = 0.56; 95% CI: 0.19 to 0.93) in the music-based intervention group compared with the control group. The aggressive behavior was significantly decreased in the music therapy group compared with the control group (SMD =
1.79; 95% CI =
3.23 to
0.35); while, no difference was observed between music medicine group and control group. Sub-group analyses exhibited a more efficacious in reducing aggressive behavior in the children received ≥2 sessions per week, the children with a mean age > 10 years, the children whose behavior were reported by teachers, and the children with aggressive behavior before intervention. Sensitivity analyses yielded similar results. Conclusion: Music-based intervention seemed to be more efficacious for reducing aggression and increasing self-control in children and adolescents, especially music therapy. Abbreviations: 95%CI = 95% confidence interval, AMTA = American Music Therapy Association, CAAI = child aggression assessment inventory, CBCL = Child Behavior Checklist, CDIH-I = Conners’ DSM-IV Hyperactive-Impulsive Scale, CGIR-I = Conners’ Global Index Restless-Impulsive, CSCR = child self-control rating scale, DBC = developmental behaviour checklist, DERS = difficulties in emotion regulation scale, I2 = I-square, PAPS = physical aggression propensity scale, PBFS = problem behavior frequency Scale, RSASB = ratings of social and anti-social behaviour, SBQ = social behavior questionnaire, SDQ = strength and difficulty questionnaire, SMDs = standardized mean differences.