Growing concerns regarding antibiotic use in livestock, due to antibiotic resistance and potential human transmission, have led to increased interest in herbs and their derivatives, including essential oils, which possess antimicrobial properties that may enhance overall productivity and serve as a strategy for methane mitigation. The objective of this meta-analysis was to investigate the effects of adding oregano to the diet in different forms (essential oils, plant materials, or leaves) on the dry matter intake (DMI), milk yield (MY), milk components, nutrient digestibility, ruminal fermentation parameters, and methane (CH4) emissions of dairy cows. A literature search was conducted to identify papers published from 2000 to 2023. Effect size for all outcomes was reported as a standardized means difference (SMD) and raw means difference with 95% confidence intervals. Heterogeneity was determined using the Q test and I2 statistic. The results of the meta-analysis indicated that adding oregano had no effect on DMI (SMD = 0.081; p = 0.507) and MY (SMD = 0.060; p = 0.665). Milk fat percentage, milk protein percentage, and milk lactose percentage were not affected by oregano. The addition of oregano to the diet significantly decreased dry matter digestibility (SMD = −0.502; p = 0.013), crude protein digestibility (SMD = −0.374; p = 0.040), and neutral detergent fiber digestibility (SMD = −0.505; p = 0.014). Ruminal pH (SMD = −0.122; p = 0.411), total volatile fatty acids concentration (SMD = −0.038; p = 0.798), acetate (SMD = −0.046; p = 0.757), propionate (SMD = 0.007; p = 0.960), and butyrate (SMD = 0.037; p = 0.801) proportion were not affected by oregano. The addition of oregano to the diet tended to decrease CH4/DMI (SMD = −0.275; p = 0.095) but did not affect CH4 production (SMD = −0.156; p = 0.282). Heterogeneity (Q and I2) was non-significant for all parameters. We conclude that the inclusion of oregano in various forms (essential oils, plant materials, or leaves) in the diet of dairy cows reduces nutrient digestibility but does not significantly affect DMI, MY, milk components, ruminal fermentation parameters, or CH4 production. Future research should focus on optimizing the dosage of oregano (both EOs and plant materials) and exploring the impact of its form on lactation, nutrient digestibility, ruminal fermentation, and CH4 emissions in dairy cows.