Abstract Objective Use the meta-analytic approach to examine the effects of aerobic exercise on total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) in children and adolescents. Study design Randomized controlled trials which were limited to aerobic exercise ≥4 weeks in children and adolescents 5–19 years of age. Results Twelve outcomes representing 389 subjects were available for pooling. Using random-effects modeling, a trend for statistically significant decreases of 12% was found for TG ( X ¯ ± S . E . M . , −11.0 ± 6.1 mg/dl; 95% CI, −22.8–0.8 mg/dl) with no statistically significant changes for TC, HDL-C, and LDL-C. Decreases in LDL-C were associated with increased training intensity ( r = −0.89; 99% CI, −0.99 to −0.04) and older age ( r = −0.90; 99% CI, −0.99 to −0.25) while increases in HDL-C were associated with lower initial HDL-C ( r = −0.75; 99% CI, −0.94 to −0.80). Statistically significant decreases in TG were observed in overweight/obese subjects with a trend for increases in HDL-C (TG, X ¯ ± S . E . M . , −23.9 ± 7.0 mg/dl; 95% CI, −37.6 to −10.1 mg/dl; HDL-C, X ¯ ± S . E . M . , 4.0 ± 2.3 mg/dl; 95% CI, −0.5–8.5 mg/dl). Conclusions Aerobic exercise decreases TG in overweight/obese children and adolescents.