Hypertension is a major risk factor for cardiovascular disease, myocardial infarction, stroke and renal failure. Sesame consumption may benefit blood pressure (BP) owing to its high polyunsaturated fatty acid, fibre, phytosterol and lignan contents. To clarify this, a systematic review and meta-analysis of controlled trials was conducted. The PubMed (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Library (Central) databases were systematically searched until August 2016. Eight controlled trials with a total of 843 participants met the eligibility criteria. A random effect meta-analysis showed that sesame consumption can reduce systolic BP (−7.83 mmHg, 95% CI: −14.12, −1.54; P < 0.05, I2 = 99%) and diastolic BP (−5.83 mmHg, 95% CI: −9.58, −2.08; P < 0.01, I2 = 98%). To reduce the heterogeneity, the meta-analysis was limited to high methodology quality trials (n = 4), which resulted in a significant reduction in systolic BP (−3.23 mmHg, 95% CI: −5.67, −0.79; I2 = 33%) and a non-significant reduction in diastolic BP (−2.08 mmHg, 95% CI: −4.85, 0.69; I2 = 62%). This study concluded that sesame consumption can reduce systolic and diastolic BP. However, further investigations with larger sample sizes and better methodology quality are required to confirm the BP-lowering effect of sesame consumption.