Background and Purpose: The low-load resistance training combined with blood flow restriction (LL-BFR) has recently been shown to promote muscle adaptation in diverse populations. However, to date, there is little evidence on whether this training regimen affects muscle strength and physical performance in healthy older adults. The objective of this systematic review and meta-analysis was to quantitatively determine the effects of LL-BFR training on lower extremity muscle strength and physical performance as compared to other training programs in healthy older adults. Methods: A PRISMA-compliant systematic review and meta-analysis was performed. The search was conducted through PubMed, Scopus, and Medline databases up to June 14th, 2022. The outcomes were knee flexor and extensor strength and physical performance in the Timed Up-and-Go and 30-second sit-to-stand tests. Intergroup differences were determined by calculating standardized mean difference (SMD) and 95% confidence intervals (CIs). Results: A total of 140 articles were screened and 8 studies were included, with a total population of N = 241. The results showed that LL-BFR significantly improved knee flexor (SMD = 1.972, 95% CI: 1.087 to 2.857, p < 0.0001) and extensor (SMD = 1.53, 95% CI: 1.033 to 2.027, p < 0.0001) strength as well as physical performance in the Timed Up-and-Go (SMD = -2.597, 95% CI: -4.458 to -0.736, p = 0.006) and 30-second sit-to-stand (SMD = 1.858, 95% CI: 0.148 to 3.568, p = 0.033) tests. Conclusions: This study suggests that LL-BFR may be an effective intervention to improve lower extremity muscle strength and physical performance in healthy older adults. As the number of studies and participants is small, further studies of higher quality are needed to demonstrate the effective application of BFR training. Clinical Relevance: LLBFR may be used to improve the lower limb muscle strength and physical performance in healthy elderly people.