Exercise is known to reduce adverse side effects of androgen-deprivation therapy (ADT) on quality of life, bone health and fatigue for prostate cancer (PCa) patients. We conducted a systematic review with meta-analysis to evaluate the effect of multidisciplinary interventions on body composition and metabolic syndrome (MetS) in ADT-treated PCa patients. A systematic review and meta-analysis were conducted based on searches of EMBASE, MEDLINE, CENTRAL and Scopus databases from inception to March 2023. Participants included ADT-treated PCa patients who received multidisciplinary interventions including exercise, diet, nutrition, pharmacotherapy, bariatric surgery, or psychological/behavioural therapy. Primary outcomes were changes in body composition and MetS, with prostate-specific antigen (PSA) as a secondary outcome. After meta-analysis, results were reported in mean difference, 95% confidence interval and p-value, with forest plots. Additionally, we conducted subgroup analyses to compare the effect of different interventions. Thirty-three articles met the eligibility criteria out of 1443 articles and 28 studies were included in meta-analysis. Of 33 studies, 17 included exercise-only interventions and 10 included exercise+diet/nutrition interventions, but no studies included diet/nutrition-only interventions. All studies employed multidisciplinary approaches in developing or delivering the interventions. Most studies (85%) had low-moderate risk of bias, thus providing good evidence to this review. Overall, interventions had a positive effect on body composition measures; lean mass (LM):0.82kg (95% CI:0.47,1.17;p<0.00001), body fat mass (BFM):-0.68kg (95% CI:-1.12,-0.24;p=0.002), fat-free mass:0.75kg (95% CI:0.14,1.37;p=0.02) and body fat percentage (BFP):-0.99% (95% CI:-1.29,-0.68;p<0.00001), as well as on MetS; waist circumference:-1.95cm (95% CI:-3.10,-0.79;p=0.0009), systolic blood pressure:-3.43mmHg (95% CI:-6.36,-0.50;p=0.02) and diastolic blood pressure:-2.48mmHg (95% CI:-4.19,-0.76;p=0.005). Subgroup-analyses showed that a combined approach including exercise+diet/nutrition was most effective in improving BFP, WC, SBP and DBP whereas exercise was more effective in improving LM and BFM. In ADT-treated PCa patients, multidisciplinary interventions, especially those combining exercise and diet/nutrition, can improve body composition and metabolic health.