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Abstract Pain could be one of the most disabling symptoms experienced by cancer patients. The current meta-analysis aims to update the available literature since 2018 and evaluate the role of reflexology on pain in treating patients with cancer. A comprehensive literature search was conducted from December 2018 to May 2024 using electronic databases such as EMBASE, Cochrane, and PubMed/ MEDLINE. Pain assessed by any validated tool was considered as the outcome measure. The quality of included studies was assessed by using the Cochrane risk of bias tool. Meta-analysis was performed by Review Manager Software (version 5.4.1). A total of 11 Randomized Controlled Trials of 681 patients with cancer are included in the updated meta-analysis. The meta-analysis findings showed the pain intensity reductions are significantly different between reflexology and control group SMD = -0.61 with 95% of CI (-1.14 to -0.09) with considerable heterogeneity suggesting that reflexology may be effective in reducing cancer pain. The current meta-analysis suggests that reflexology likely to be an effective intervention to reduce pain associated with cancer. However, the certainty of evidence was very low. Further robust research is needed to better characterize the role of reflexology in cancer pain management.