Background: Lepidium meyenii Walp. (LmW), known as maca, has been shown to increase physical performance. However, the effect size (ES) of LmW on the different manifestations of physical performance has not yet been described. Objectives: To examine and qualitatively describe the studies published up to 2024 that employed LmW supplementation to increase physical performance in animal and human experimentation. In addition, the ES associated with the different interventions was calculated. Methods: The research followed PRISMA® guidelines for systematic reviews and meta-analyses, using Web of Science, Scopus, SPORTDiscus, PubMed, and MEDLINE databases until 2024. Randomized controlled studies with a pre- and post-test design, conducted both in vitro and in vivo in animals and humans, were included. Methodological quality assessment was performed using the CAMARADES tool for animal studies and the Newcastle Ottawa Scale for human studies. The main variables were the forced swimming test (FST), the rota-rod test (RRT), the grip strength test (GST), blood lactic acid (BLA), and lactic acid (LA). The analysis was conducted with a pooled standardized mean difference (SMD) through Hedges’ g test (95% CI). Results: Twenty-one studies were included in the systematic review and sixteen in the meta-analysis. They revealed a large effect for all outcomes (SMD: FST = 2.26, RRT = 6.26, GST = 5.23, LA = −1.01, and BLA = −1.70). Conclusions: The phytochemical compounds of LmW, mainly macamides, increase physical performance, showing a greater effect at higher doses (dose–response effect).