Public speaking can be a fear-inducing and anxiety-provoking experience for individuals, potentially resulting in poor performance and missed educational, social, and professional opportunities. In order to provide applied practitioners with effective methodologies for the reduction of public speaking anxiety (PSA), this paper aims to systematically review and meta-analyse theoretically driven interventions that successfully reduce PSA or maintain/increased public speaking performance. Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, a systematic review and meta-analysis examined articles from 1st January 2000 to 1st June 2023. Of the 1,293 articles identified, 26 studies with 2,253 participants met the inclusion criteria. Research was of a moderate to high methodological standard, with interventions varying in type, duration, and focus (e.g., symptom vs. source). Intervention types included exposure, cognitive modification, combined, and other strategies. Although, the overall effect of psychological interventions for PSA across 42 interventions was g = 1.17 (95% CI = 0.88-1.45), with high heterogeneity, individual effect sizes varied greatly. While this review provides support for the efficacy of psychological interventions in reducing anxiety related to public speaking, rigorous research is warranted to examine long-term efficacy, real-world implications, self-efficacy development, and individual differences in treatment assignment. Finally, this review provides practitioners with a quick and easy guide to implementing successful interventions that reduce PSA or maintain/increase performance.