Alexander technique (AT), a process of psychophysical re-education, is being promoted for a range of medical conditions. This systematic review was aimed at critically evaluating the evidence for or against the effectiveness of AT. Computerised literature searches were performed in five databases to locate all CCTs of AT in any human condition. Data were extracted independently by two reviewers according to predefined criteria. The information was summarised in tabular and narrative form. The methodological quality of the primary studies was assessed using the Jadad score. Four clinical trials met the inclusion/exclusion criteria. Only two of these trials were methodologically sound and clinically relevant. Their results are promising and imply that AT is effective in reducing the disability of patients suffering from Parkinson’s disease and in improving pain behaviour and disability in patients with back pain.