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Objectives To evaluate the effectiveness of a dual-target deep brain stimulation (DBS) approach, stimulating both the subthalamic nucleus (STN) and the substantia nigra pars reticulata (SNr), and improvement of gait function and quality of life (QoL) in patients with Parkinson’s disease (PD).Design Systematic review and meta-analysis of crossover randomised controlled trials (RCTs).Setting A systematic search was conducted across PubMed, ScienceDirect and Scopus databases up to October 2025.Participants Adults with advanced PD (disease duration >5 years) experiencing clinically significant and refractory freezing of gait (FoG) despite optimal dopaminergic therapy and standard STN-DBS.Interventions Dual-target DBS stimulation of the STN and SNr compared with conventional STN-only stimulation.Main outcome measures FoG and QoL.Results Eight crossover RCTs (n=97) were included. Combined STN+SNr resulted in a significant reduction in FoG compared with STN stimulation alone (standard mean difference=−0.39 (95% CI −0.73 to −0.04), I 2=23.2%). No significant difference was observed in QoL (mean difference=−0.79 (95% CI −1.92 to 0.34), I2=0%). Meta regression revealed high-frequency stimulation in both targets was a significant moderator for gait improvement (95% CI −0.96 to −0.05, I2=39.2%). Adverse effects were generally transient and reversible.Conclusions Combined STN and SNr stimulation provides significant clinical benefit for refractory FoG in advanced PD. However, this motor improvement did not translate into immediate QoL gains. Further investigation of RCTs and integrated rehabilitative management are essential to establish broader applicability and its long-term value.PROSPERO registration number CRD42025632066.