Given the current aging population, the demand on medical facilities, facilities for elderly care, and even their high prevalence, it is crucial to investigate the advantages of older people. The amount of scholarly literature examining natural factor-related activities to enhance older people’s health status has steadily risen over the last few decades. But the scope of the present review is limited. We compiled the results of 33 peer-reviewed publications and conducted a meta-analysis using a total of 27 relevant variables to assess the advantages of horticultural therapy (HT) for, among other things, the physical and psychological functioning of the elderly. Results show that horticultural therapy may be helpful in helping seniors lose weight -0.195 (95% CI -0.507,0.117), reduce their waist circumference -0.327 (95% CI -0.637, -0.017), improve their physical flexibility (chair sit-and-reach) 0.302 (95% CI 0.036, 0.569), lower their stress -0.339 (95% CI -0.610, -0.069) and cortisol -0.902 (95% CI -0.728, -0.002) levels, improve social interaction 0.370, (95% CI 0.115, 0.624), increase daily vegetables and fruit consumption 0.688 (95% CI: 0.287, 1.089). HT may be a useful tool for enhancing the physical, mental and social aspects of older adults.