PURPOSE: We conducted a systematic review to assess the effectiveness of TENS in the rehabilitation of limb motor dysfunction following stroke. MATERIALS AND METHODS: We collected data from three databases, PubMed, Embase, and Web of Science, covering the earliest available date to April 2024, with a focus on randomized controlled trials that utilized TENS as an intervention for limb motor dysfunction after stroke, and extracted the main evaluation indicators before and after treatment, including the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Functional Independence Measure (FIM), and Composite Spasticity Scale (CSS). Meta-analysis was conducted using Review Manager 5.4.1 software. RESULTS: This systematic review included a total of 513 participants from 10 studies. The analysis revealed that TENS was found to be statistically more effective than sham TENS in improving upper limb function, with a standardized mean difference (MD) of 3.58 (95% CI: 0.88, 6.27). CONCLUSION: TENS has shown potential in improving limb motor function in post-stroke patients based on FMA-UE, FIM, and CSS scores. However, variations in stimulation frequency, sites, treatment schedules, and devices make the evidence insufficient for its reliable clinical use. UNLABELLED: Registration: CRD42023421759.