Androgenetic alopecia (AGA) is a common cause of hair loss in both men and women. Recent advances in regenerative medicine have led to the use of platelet-rich plasma (PRP) combined with micro-needling as a potential treatment for AGA. However, the clinical effectiveness of this combination therapy remains unclear. To evaluate the efficacy and safety of platelet-rich plasma (PRP) combined with micro-needling for the treatment of androgenetic alopecia through a systematic review and meta-analysis of available clinical studies. A systematic search was conducted in PubMed, Embase, and the Cochrane Library for studies published up to January 2024. Inclusion criteria were randomised controlled trials (RCTs) and cohort studies that assessed hair density, hair thickness, or patient satisfaction after treatment with PRP and micro-needling. Data were extracted and pooled using a random-effects model, and heterogeneity was assessed with the I² statistic. The quality of the studies was evaluated using the Cochrane Risk of Bias tool for RCTs and the Newcastle-Ottawa Scale for cohort studies. A total of 12 studies involving 546 participants were included. Meta-analysis showed that the combination of PRP and micro-needling significantly increased hair density (mean difference: 18.9 hairs/cm², 95% CI: 15.3-22.5, p < 0.001) and hair thickness (mean difference: 0.4 mm, 95% CI: 0.3-0.5, p < 0.01) compared to controls. Patient satisfaction was also higher in the treatment group. The most commonly reported adverse effects were mild scalp irritation and transient erythema, with no serious adverse events. Moderate heterogeneity was observed among the studies (I² = 42%). The combination of PRP and micro-needling is an effective and well-tolerated treatment for androgenetic alopecia, resulting in significant improvements in hair density and thickness. Further large-scale, high-quality trials are needed to confirm these findings and standardize treatment protocols.