This meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered with PROSPERO (CRD420251131469). Comprehensive searches of PubMed, Embase, Scopus, Cochrane Library, Google Scholar, and ClinicalTrials.gov were performed up to July 2025. Eligible studies included randomized controlled trials (RCTs) and observational studies comparing cognitive rehabilitation with standard care. Risk of bias was assessed using Cochrane RoB 2.0 and Newcastle-Ottawa Scale; certainty of evidence was graded using GRADE.

Out of 152 records identified, four studies met inclusion criteria (three RCTs and one cohort). Cognitive rehabilitation was associated with significant improvements in verbal recall (SMD 0.59, 95% CI 0.16–1.03) and digit span (SMD 0.49, 95% CI 0.19–0.79), both supported by high-certainty evidence. In contrast, no significant effects were observed for attention (SMD 0.14, 95% CI –0.30–0.58) or global cognition (SMD 0.07, 95% CI –0.22–0.36).

Cognitive rehabilitation enhances verbal recall and working memory in brain tumor patients, while benefits for attention and global cognition remain inconclusive. Larger, multicenter RCTs with standardized protocols are needed to validate and extend these findings.