Essential oils (EOs) are widely used topically in musculoskeletal disorders (MSDs); however, their clinical efficacy is controversial. Our aim was to find evidence that topical EOs are beneficial as an add-on treatment in MSDs. We performed a systematic review and meta-analysis to summarize the evidence on the available data of randomized controlled trials (RCTs). The protocol of this work was registered on PROSPERO. We used Web of Science, EMBASE, PubMed, Central Cochrane Library and Scopus electronic databases for systematic search. Eight RCTs were included in the quantitative analysis. In conclusion, EO therapy had a favorable effect on pain intensity (primary outcome) compared to placebo. The greatest pain-relieving effect of EO therapy was calculated immediately after the intervention (MD of pain intensity = -0.87; = 0.014). EO therapy had a slightly better analgesic effect than placebo one week after the intervention (MD of pain intensity = -0.58; = 0.077) and at the four-week follow-up as well (MD of pain intensity = -0.52; = 0.049). EO therapy had a beneficial effect on stiffness (a secondary outcome) compared to the no intervention group (MD = -0.77; = 0.061). This systematic review and meta-analysis showed that topical EOs are beneficial as an add-on treatment in reducing pain and stiffness in the investigated MSDs.