Objective To systematically evaluate the impact of meaning in life intervention, rooted in Frankl’s theory of logotherapy, on the spiritual, psychological and quality of life in cancer patients. Methods Databases including Medline, The Cochrane Library, Embase, Web of Science, CINAHL, CBM, CNKI, Wanfang Data and VIP were searched. RevMan 5.4 was used for meta-analysis.Results Nine randomized controlled trials involving 1082 patients were included. Meaning in life intervention enhanced meaning in life (SMD=-0.24, 95% CI:-0.40~-0.07, P=0.006), spiritual well-being (MD=-0.32, 95% CI:-0.48~- 0.15, P=0.0001), and reduced hopelessness (SMD=-1.39, 95% CI:-2.53~-0.24, P=0.02) and depression (SMD=-0.82, 95% CI:-1.61~-0.03, P=0.04) in cancer patients. Subgroup analysis revealed that the intervention was more effective in reducing anxiety (SMD=-0.43, 95% CI: -0.64~-0.23, P<0.0001) and improving the quality of life (SMD=-0.60, 95% CI:-0.88~-0.33, P<0.0001) for patients with solid tumors or non-Hodgkin’ s lymphoma. Conclusion Meaning in life intervention based on Frankl’s logotherapy theory significantly improved the meaning in life and spiritual well-being, and alleviated hopelessness and depression in cancer patients. The intervention also effectively reduced anxiety compared with usual care and enhanced the quality of life for patients with solid tumors or non-Hodgkin‘s lymphoma.