Purpose This study was designed to critically evaluate the effect of music interventions on cancer-related fatigue (CRF) in cancer patients. Methods Seven databases (Cochrane Library, PubMed, Embace, CBM, Wanfang, VIP, and CNKI) were systematically reviewed from inception to June 2020 for randomized controlled trials (RCTs). Two reviewers critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed form. All analyses were performed with Review Manager 5.3. Results A total of 8 qualified studies that included 467 patients (music interventions: 235, control: 232) were included. Cancer patients who completed adjuvant therapy in the music intervention group, especially those with malignant hematological diseases, reported reduced CRF levels compared with patients undergoing routine care. Regardless of the frequencies, music interventions can relieve fatigue in cancer patients. Providing prerecorded music and participating in live music both can mitigate CRF. Conclusions Music interventions can be considered as an alternative therapy for relieving fatigue in cancer patients who are undergoing active treatment or have completed treatment.