Objective. This study systematically evaluated the effects of Tai Chi exercise on blood pressure, body mass index (BMI), and quality of life (QOL) in patients with hypertension. A meta-analysis was performed to provide a reliable reference for clinical practice. Methods. We searched for randomized controlled trials (RCTs) in five English databases and two Chinese databases, with the earliest data dated December 5, 2020. A quality assessment of the methods and a meta-analysis were also conducted. Results. The meta-analysis of 24 studies showed that the intervention group showed better outcomes in terms of systolic blood pressure (SBP) (SMD −1.05, 95% CI −1.44 to −0.67,
P
≤
0.001
; I2 = 93.7%), diastolic blood pressure (DBP) (SMD −0.91, 95% CI −1.24 to −0.58,
P
≤
0.001
; I2 = 91.9%), and QOL (physical functioning (SMD 0.86, 95% CI 0.36 to 1.37,
P
=
0.001
; I2 = 91.3%), role-physical (SMD 0.86, 95% CI 0.61 to 1.11,
P
≤
0.001
; I2 = 65%), general health (SMD 0.75, 95% CI 0.32 to 1.17,
P
=
0.001
; I2 = 88.1%), bodily pain (SMD 0.65, 95% CI 0.29 to 1.00,
P
≤
0.001
; I2 = 83.1%), vitality (SMD 0.71, 95% CI 0.34 to 1.07,
P
≤
0.001
; I2 = 84.3%), social functioning (SMD 0.63, 95% CI 0.07 to 1.19,
P
=
0.027
; I2 = 93.1%), role-emotional (SMD 0.64, 95% CI 0.22 to 1.06,
P
=
0.003
; I2 = 88.1%), and mental health (SMD 0.73, 95% CI 0.31 to 1.16,
P
=
0.001
; I2 = 88.2%)) compared to those of the control group. However, no significant improvements were seen in BMI of the intervention group (SMD −0.08, 95% CI −0.35 to −0.19,
P
=
0.554
; I2 = 69.4%) compared to that of the control group. Conclusion. Tai Chi is an effective intervention to improve SBP and DBP in patients with essential hypertension.