PurposeThe purposes of this systematic review and meta‐analysis were to: 1) appraise the available evidence of telerehabilitation program effects on functional outcomes, adherence and patient satisfaction compared to face‐to‐face programs after stroke, and 2) provide direction for future outcome measure selection and development for clinical research purposes.MethodsMEDLINE, CINAHL, Embase, Scopus, Proquest Theses and Dissertations, PEDro, and Clinical Trials.gov were searched for studies published in English from 1964 to the end of April 2022. A total of 6,450 studies were identified, 13 were included in the systematic review and 10 with at least 3 reported similar outcomes were included the meta‐analysis. Methodological quality of results was evaluated using the PEDro checklist.ResultsTelerehabilitation demonstrated equivalency in outcomes across several domains and was favored compared to conventional face‐to‐face alone or when paired with semi supervised physical therapy on Wolf Motor Function performance score (mean difference [MD] 1.68 points, 95% CI 0.21 to 3.17) and time score (MD 2.07 seconds, 95% CI ‐4.04 to –0.098, Q test=30.27, p<0.001, I2=93%), and Functional Mobility Assessment in the upper extremities (MD 3.32 points, 95% CI 0.91 to 5.74, Q test=5.60, p=0.23, I2=29%alone or when paired with semi‐supervised physical therapy). The Barthel Index participation measures of function demonstrated improvement (MD 4.18 points, 95% CI, 1.78 to 6.57, Q test=3.56, p=0.31, I2 =16%). Over half of summarized study ratings were determined to be of low to moderate quality (PEDro score 6.54 ± 2.11 points). Adherence varied in available studies from 75%‐100%. Satisfaction levels of telerehabilitation were highly variable.ConclusionsTelerehabilitation can improve functional outcomes and promote therapy adherence post‐stroke function. Therapy protocols and functional assessments need substantial refinement and standardization to improve interpretation and clinical outcomes.This article is protected by copyright. All rights reserved.