Background: Although children with intellectual disabilities (ID) are at greater risk of falls from poorer balance ability than typically developing children, reliable information about which types of physical intervention are most effective is scarce.

Objective: A meta–analysis was used to examine the most effective programs on balance ability in children with ID.

Method: 77 effect sizes from 10 studies and the standardised mean differences in effect size were calculated using the random effects model.

Results: Fitness exercise, combined strength and proprioceptive training, dual-task functional exercises, trampoline exercise, hippotherapy, and core strength training were effective interventions. Duration of exercises should be less than or equal to 10 weeks. Exercises performed three times per week and sustained for 45–60 min had the largest effect. Balance ability of 5–13-year-old children could be improved by a larger margin through physical exercise than 14–18-year-old children.

Conclusions: Six intervention programs proved to be effective on balance and feasible for physical education in schools. Attractive and integrated sports programs were highly recommended. Systematic review registration number: CRD42018092558.

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