Data from 27 RCTs, spanning 1265 patients, was pooled and analyzed to evaluate the benefits of aquatic physical therapy in the treatment of fibromyalgia. Relevant evidence from 1970 to 2012 was investigated and the results presented in this meta-analysis and systematic review indicated that aquatic physical therapy for fibromyalgia treatment demonstrated superior functional ability, stiffness and walking outcomes compared to no treatment at 20 weeks. No significant differences were apparent between aquatic physical therapy and land based exercise for any of the outcomes measured within the studies.