Purpose: Beetroot juice (BJ), a natural source of dietary nitrate, has been widely studied for its potential ergogenic effects; however, evidence integrating both aerobic and anaerobic performance outcomes remains limited. This meta-analysis evaluated the effects of BJ supplementation on maximal oxygen uptake (VO2max), high-intensity interval sprint (HIS) performance, and mean power output (MPO). Methods: A comprehensive literature search was conducted across six databases (Wiley Online Library, Web of Science, Scopus, SpringerLink, PubMed, and ScienceDirect), supplemented by manual searches of Google Scholar. Meta-analysis, subgroup analysis, meta-regression analysis, publication bias assessment, and sensitivity analyses were performed using Stata 17. Results: Thirty-three studies were included in the review. BJ supplementation significantly improved HIS (SMD=0.38, 95% CI 0.17 to 0.59, p<0.001), MPO (SMD=0.43, 95% CI 0.21 to 0.64, p<0.001), and VO2max (SMD=0.30, 95% CI 0.05 to 0.55, p<0.001). Heterogeneity was low across all outcomes (HIS: I2=11.0%, p=0.343; MPO: I2=0.0%, p=0.824; VO2max: I2=0.0%, p=0.970). In addition, although subgroup difference tests did not show statistically significant differences, the observed data suggest that athlete status, sport type, supplementation strategy, juice brand, and timing of intake may act as potential effect modifiers. These findings should be interpreted as hypothesis-generating and require confirmation in future studies. Conclusion: As a natural ergogenic aid, beetroot juice effectively improves both aerobic and anaerobic exercise performance and can be recommended.
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