Background: Bone mineral density (BMD) is crucial for bone health, contributing up to 50% of total bone mineral content during childhood and pre-adolescence, with the accumulation of bone mass in youth significantly impacting adult bone health. Physical activity, especially impact exercise, plays a fundamental role in strengthening bones. Objectives: The aim of this meta-analysis was to study the
... [Show full abstract] effects of basketball practice on BMD compared to other sports and free activity practice in children and adolescents. Methods: Observational studies were selected up to January 2024. A total of 492 articles were identified, of which 9 met the criteria for inclusion in the meta-analysis. Results: The BMD increase favored the group of basketball players in the total body (MD 0.07; CI 0.04 to 0.09; p < 0.001; I2 = 93%), upper limbs (MD 0.10; CI 0.008 to 0.12; p < 0.001; I2 = 96%), and lower limbs (MD 0.05; CI 0.03 to 0.07; p < 0.001; I2 = 80%). Conclusions: Basketball practice in children and adolescents appears to be one of the most effective sports for enhancing BMD (total body and upper and lower limbs) compared to football, swimming, combat sports, other team sports, such as baseball and volleyball, as well as athletics and gymnastics. The high heterogeneity among studies, largely due to differences in sports, may limit the interpretation of the findings.