Background: Hypertension is the major attributable risk factor for cardiovascular disease. The effect of Tai Chi on essential hypertension (EH) is contentious. Objectives: In this study, we investigated the effects of Tai Chi on the risk factors for cardiovascular disease and quality of life in adults with EH. Methods: Using data collected from 15 databases up to December 2018, we meta-analyzed randomized controlled trials of the effect of Tai Chi on EH. Results: Tai Chi exercise was associated with lower systolic blood pressure (SBP) (WMD -12.47, 95%CI -16.00 to -8.94, P < 0.001) and diastolic blood pressure (DBP) (WMD -6.46, 95%CI -8.28 to -4.64, P < 0.001); better quality of life (SMD 0.62, 95% CI 0.35 to 0.90, P < 0.001); lower lipid profiles, including total cholesterol (WMD -0.49, 95% CI -0.62 to -0.37, P < 0.001), triglycerides (WMD -0.49, 95% CI -0.92 to -0.07, P = 0.02), and low-density lipoprotein-cholesterol (LDL-C) (WMD -0.86, 95% CI -1.30 to -0.43, P < 0.001); and lower blood glucose (WMD -0.91, 95% CI -1.59 to -0.23, P = 0.009). Tai Chi had no significant effect on high-density lipoprotein-cholesterol (WMD -0.92, 95% CI -2.21 to -0.37, P = 0.16). Conclusions: Tai Chi lowers blood pressure, total cholesterol, triglycerides, LDL-C, and blood glucose and significantly increases the quality of life in adults with EH. There is strong evidence for the short-term efficacy of Tai Chi exercises. Larger well-designed RCTs focused on the long-term effect of Tai Chi exercises and patient adherence are needed. (C) 2020 Published by Elsevier Inc.