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Background: Goal setting is commonly used for promoting physical activity (PA) among insufficiently active individuals. Previous reviews have analyzed the effects of goal setting on PA, but the purpose of this systematic review was to examine the concurrent effects of goal setting on PA and psychological outcomes in insufficiently active individuals to support interventions aiming to produce sustained PA behavior change. Methods: In this review (PROSPERO: CRD42021243970), we identified 13 studies with 1208 insufficiently active adults that reported the effects of goal-setting interventions (range 3–24 wk) on both PA and psychological outcomes (eg, self-efficacy, motivation, and affect). We used meta-analysis and narrative synthesis to analyze these effects. Results: All goals used in the included studies were specific goals. Setting specific goals had a large, positive effect on PA (g [standard mean difference] = 1.11 [P <.001]; 95% confidence interval, 0.74–1.47), but only a small, positive effect on the combined psychological outcomes (g [standard mean difference] = 0.25 [P <.001]; 95% CI, 0.10–0.40). Moderator analyses revealed that interventions that did not reward participants had a significantly greater effect on PA than interventions that did provide rewards (g = 1.30 vs 0.60, respectively, P ≤.003). No other significant moderators were found. Conclusion: Our review offers initial insight into the long-term effects of specific goals on PA and psychological outcomes in insufficiently active adults. Further research that examines the PA and psychological effects of goal-setting interventions and investigates a wider range of goal types could develop a stronger evidence base to inform intervention for insufficiently active individuals. [ABSTRACT FROM AUTHOR]