Background: Intradialytic exercise has emerged as a favorable option for dialysis patients due to its benefits, like enhanced toxin removal, time efficiency, and safety. Previous studies have delved into the effects of such exercises on the quality of life (QOL) in hemodialysis patients. This can also help with improved nutrition, bone density, cardiovascular endurance, and functional ability. Methods: Relevant electronic databases were searched from 2016 to December 2023. We included randomized controlled trials focusing on intradialytic cycling exercises in patients undergoing hemodialysis. Two review authors independently screened articles and evaluated bias risks. Outcome measures related to intradialytic cycling exercises and hemodialysis patients and their effect on functional performance and QOL were extracted and summarized through qualitative and quantitative methods. Results: Five trials were selected based on their high-quality methodology. They investigated whether research on intervention techniques were diverse or not. Qualitative analysis was conducted on the findings, which revealed moderate evidence in five articles about the effect of intradialytic cycling exercises on functional performance and QOL in patients undergoing hemodialysis. Meta-analysis was applied, and it showed that, the strategy of performing intradialytic aerobic cycling exercise during the process of dialysis showed higher levels of physical activity and fitness. Conclusion: Based on our evidence in this systematic review and meta-analysis, this review found moderate evidence that, the intervention of intradialytic aerobic cycling exercise on HD alleviates inflammation, increases bone density, improve nutrition, exercise tolerance and induced higher levels of physical activity and fitness.