<title>Abstract</title> Background Neuromuscular diseases (NMDs) represent a diverse group of disorders characterized by progressive impairment of skeletal muscle strength and respiratory function. These disorders pose significant challenges to individuals’ daily activities and overall quality of life. Respiratory complications are common and contribute to high morbidity and mortality rates. Physiotherapy, especially respiratory muscle training, is often recommended as a key intervention to manage and possibly reverse some of these respiratory impairments. Methods A systematic review and meta-analysis were conducted to evaluate the effectiveness of physiotherapy interventions on respiratory muscle function in adults with NMDs. The databases searched included Ovid MEDLINE, EMBASE, Web of Science, and others. The outcomes assessed were lung volume and capacity, inspiratory and expiratory muscle strength, and the frequency of respiratory distress episodes. Results Of the 7669 identified articles, 25 met the inclusion criteria. Most studies showed a low to moderate risk of bias. The meta-analysis revealed nonsignificant increases in various respiratory parameters, including FVC%, MIP, and MEP. However, a systematic review indicated that more than two-thirds of the study population experienced improved respiratory muscle strength due to physiotherapy interventions. Notably, there was considerable heterogeneity among the studies, which impacted the overall statistical significance of the meta-analysis results. Conclusion This review highlights the potential benefits of physiotherapy, particularly RMT, in improving respiratory muscle strength in patients with NMDs. Despite the variability and lack of statistical significance in the meta-analysis, the systematic review suggested that physiotherapy can be a valuable intervention. Future research should aim to standardize interventions and outcome measures to provide more definitive evidence on the efficacy of physiotherapy for respiratory complications in NMD patients.