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Objective The authors of this systematic review with meta-analysis evaluated the evidence for the effectiveness of various applications of dry needling (DN) combined with other conservative treatments for subacromial pain syndrome (SAPS). Methods Six databases (PubMED, CINALH, Biosis, Web of Science, SPORTDiscus and Cochrane Central register of Controlled Trials) were searched following PROSPERO registration. The authors included randomized clinical trials investigating clinical effects of DN in combination with other conservative interventions for SAPS. Outcomes included pain and/or disability. Results Eight studies were selected. All eight studies involving 10 comparisons were included in the analyses (N-538). Random-effects model analyzed between-group effects. Dry needling performed in combination with other conservative interventions produced favorable outcomes at all time points for pain and disability. Standard mean difference ranged from -0.57 (moderate) to -1.29 (large) for pain and -0.69 (moderate) to -1.07 (large) for disability favoring groups receiving DN in addition to conservative treatment. Four of the eight studies were rated as unclear or high risk of bias. Conclusion The meta-analysis suggests various applications of DN performed with other conservative interventions are more effective than conservative treatment alone for reducing pain and disability in patients with SAPS. Direct comparison studies are needed to determine if one application of DN is superior to another. PROSPERO Registration CRD42022303063