The aim was to systematically review and meta-analyze the current evidence for the effects of resistance training (RT) on blood pressure (BP) as the main outcome and body mass index (BMI) in children and adolescents. Two authors systematically searched the PubMed, SPORTDiscus, Web of Science Core Collection and EMBASE electronic databases. Inclusion criteria were: (1) children and adolescents (aged 8 to 18 years); (2) intervention studies including RT and (3) outcome measures of BP and BMI. The selected studies were analyzed using the Cochrane Risk-of-Bias Tool. Eight articles met inclusion criteria totaling 571 participants. The mean age ranged from 9.3 to 15.9 years and the mean BMI of 29.34 (7.24) kg/m²). Meta-analysis indicated that RT reduced BMI significantly (mean difference (MD): −0.43 kg/m² (95% CI: −0.82, −0.03), P = 0.03; I² = 5%) and a non-significant decrease in systolic BP (SBP) (MD: −1.09 mmHg (95% CI: −3.24, 1.07), P = 0.32; I² = 67%) and diastolic BP (DBP) (MD: −0.93 mmHg (95% CI: −2.05, 0.19), P = 0.10; I² = 37%). Limited evidence suggests that RT has no adverse effects on BP and may positively affect BP in youths. More high-quality studies are needed to clarify the association between RT and BP in light of body composition changes throughout childhood and adolescence.