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Caregivers of adults with cancer often provide prolonged demanding assistance (e.g., physical, emotional) to their loved ones, resulting in caregiver burden. This meta-analytic review examined the efficacy of psychosocial interventions in reducing caregiver burden in caregivers of adults with cancer. Randomized controlled trials (RCTs) were identified from six electronic databases and clinical trial registries. Random-effects meta-analyses were conducted for subgroups of interventions and control conditions. Overall, 90 records describing 50 RCTs showed that psychosocial interventions reduced caregiver burden compared to passive controls (e.g. wait-list) at post-intervention (g = 0.26, 95%CI [0.12, 0.40]), but not at the first follow-up (g = 0.10, 95%CI [−0.05, 0.24]). Subgroup analyses showed that compared to passive controls, therapeutic counseling and skills training interventions significantly reduced caregiver burden at post-intervention, whereas psycho-education/support interventions did not significantly reduce burden. Very few RCTs examined intervention efficacy compared to active controls (e.g., psycho-education/support). The evidence grade ranged from very low to moderate due to inconsistency and imprecision of the results. Therapeutic counseling and skills training interventions appear efficacious in improving caregiver burden at post-intervention, although these improvements attenuate over time. Rigorous trials examining intervention effects on long-term outcomes are needed to better understand the effective mechanisms to sustain reduction in caregiver burden. • A meta-analytic review of psychosocial interventions for cancer caregiver burden. • Results revealed small significant intervention effects at post-intervention. • Therapeutic counseling and skills training interventions showed greater promise. • Carer age, gender, race, and relationship were significant moderators. • Clinical implications and future directions for research are discussed. [ABSTRACT FROM AUTHOR]