To determine the effect of exercise on pain self-efficacy in adults with non-specific chronic low back pain (NSCLBP). Intervention systematic review with meta-analysis We searched the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, PsycInfo and CINAHL databases to the 23/03/2022. We included randomised controlled trials that compared the effect of exercise on pain self-efficacy to control, in adults with NSCLBP. We conducted a meta-analysis using a random effects model. We evaluated the risk of bias using the Cochrane risk of bias tool (RoB2) and judged the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. Seventeen trials were included, of which eight (n=1121 participants, 60.6% female, mean age 49.6 years) were included in the meta-analysis. Exercise increased pain self-efficacy by 3.02 points (95% confidence interval 1.72 to 4.32) on the 60-point Pain Self-Efficacy Questionnaire. The certainty of evidence was moderate; all trials were at high risk of bias. There was moderate certainty evidence that exercise increased pain self-efficacy in adults with NSCLBP. Future research should investigate if this effect is meaningful, whether it increases with more targeted treatments to enhance pain self-efficacy, and the effects on outcomes for adults with NSCLBP.