Objective We aimed to compare the efficacy of isometric exercise training (IET) versus high-intensity interval training (HIIT) in the management of resting blood pressure (BP). Design Systematic review and meta-analysis. Data sources PubMed (MEDLINE), the Cochrane library and SPORTDiscus were systematically searched. Eligibility criteria Randomised controlled trials published between 1 January 2000 and 1 September 2020. Research trials reporting the effects of IET or HIIT on resting BP following a short-term intervention (2–12 weeks). Results 38 studies were analysed (18 IET and 20 HIIT), including 1583 (672 IET and 911 HIIT) participants, of which 612 (268 IET and 344 HIIT) were controls. IET produced significantly greater reductions in resting BP compared with HIIT with systolic, diastolic and mean BP effect sizes of 8.50mm Hg vs 2.86mm Hg (Q=17.10, p<0.001), 4.07mm Hg vs 2.48mm Hg (Q=4.71, p=0.03) and 6.46mm Hg vs 3.15mm Hg (Q=4.21, p=0.04) respectively. However, HIIT reduced resting heart rate significantly more than IET (3.17bpm vs 1.34bpm, Q=7.63, p=0.006). Conclusion While both modes are efficacious, IET appears to be the superior mode of exercise in the management of resting BP. However, HIIT may achieve wider physiological benefits, with greater reductions in resting heart rate.