Objectives: Weight gain is the main criterion for hospital discharge. This study measured the effectiveness of treating preterm neonates with massage therapy. Design: Systematic review and meta-analysis of randomized controlled trials. Data sources: Web of Science, Ovid-Medline, CINAHL, ProQuest, and PubMed (up to July 24, 2018). Study selection: Randomized controlled trials involving preterm infants with very-low-birth weight or low-birth-weight that examined the effect of massage therapy, and at least one outcome assessing infants' weight change or weight gain. Results: Pooled effect estimate from 15 trials with 697 participants showed that massage therapy improved daily weight gain by 5.07 g/day (95% CI 2.19-7.94, p = 0.0005). More benefits were observed when preterm neonates received moderate pressure massage (5.60 g/day, 95% CI 2.64-8.56, p = 0.0002) than when receiving light-pressure therapy (1.08 g/day, 95% CI 0.29-1.86, p = 0.007). Conclusions: Massage therapy is beneficial for preterm infant weight gain.