It remains unclear whether metabolic profiles differ within the subtypes of primary aldosteronism (PA). This meta‐analysis aimed to compare the blood parameters related to lipid and glucose metabolism at baseline between unilateral PA and bilateral PA. A search was performed using PubMed, Web of Science, and Sciencedirect databases, supplemented by hand‐searching of related references. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated for each parameter. Twenty‐one studies involving 4197 patients with PA were included. Compared with bilateral PA groups, unilateral PA groups demonstrated significantly lower low‐density lipoprotein cholesterol (LDL‐C, SMD: −.14 mmol/L, 95% CI: −.20, −.07), total cholesterol (TC, SMD: −.16 mmol/L, 95% CI: −.23, −.09), triglyceride (TG, SMD: −.22 mmol/L, 95% CI: −.29, −.16), fasting blood glucose (FBG, SMD: −.11 mmol/L, 95% CI: −.18, −.04), hemoglobin A1c (HbA1c, SMD: −.21%, 95% CI: −.30, −.13), and homeostasis model assessment‐insulin resistance (HOMA‐IR, SMD: −.40, 95% CI: −.58, −.23). No significant difference was found in high‐density lipoprotein cholesterol (HDL‐C) level between the two groups (SMD: .40 mmol/L, 95% CI: −.02, .11). To sum up, comparison of several blood metabolic parameters between the two subtypes suggested that the bilateral PA may associate with a higher prevalence of impaired glucose and lipid metabolism than unilateral PA; however, results should be treated with caution. Additional well‐designed studies are needed to prove the present results and better elucidate the link between metabolic abnormalities and etiologies of each PA subtype.