Although pressure therapy (PT) represents the standard care for prevention and treatment of hypertrophic scar (HS) from burns, its practice is largely based on empirical evidence and its effectiveness remains controversial. To clarify the effect of PT (15–25 mmHg) for HS, we performed the systematic review and meta-analysis. Several electronic databases were screened to identify related randomized controlled trials (RCTs). 12 RCTs involving 710 patients with 761 HS resulting from burn injuries were included. Compared with non/low-PT, cases treated with PT (15–25 mmHg) showed significant differences in Vancouver Scar Scale score (MD = −0.58, 95% CI = −0.78–−0.37), thickness (SMD = −0.25, 95% CI = −0.40–−0.11), brightness (MD = 2.00, 95% CI = 0.59–3.42), redness (MD = −0.79, 95% CI = −1.52–−0.07), pigmentation (MD = −0.16, 95% CI = −0.32–−0.00) and hardness (SMD = −0.65, 95% CI = −1.07–−0.23). However, there was no difference in vascularity (MD = 0.03, 95% CI = −0.43–0.48). Our analysis indicated that patients with HS who were managed with PT (15–25 mmHg) showed significant improvements. Due to limitations, more large and well-designed studies are needed to confirm our findings and the side-effects of the PT may also need to be evaluated.