OBJECTIVE: Mindfulness-based interventions (MBI) have been related with improved job satisfaction, wellbeing, health, and reduced workplace stress with employees. However, until now, synthesis of the evidence of the effect of MBIs on physiological indices associated with stress and ill-health has been lacking. Therefore the current systematic review aimed to synthesise the literature from employee samples to provide guidance for future investigations in terms of which physiological indicators and biological systems may be most impacted by MBIs. METHODS: Electronic databases were searched. Studies that conducted a mindfulness-based program with an employee sample, which targeted workplace stress or work engagement, and measured a physiological outcome were selected for inclusion. Studies using either a between-group or within-group design were included. Nine papers were found to meet the inclusion criteria for our systematic review and meta-analysis of the literature. RESULTS: MBIs were found to be effective in reducing cortisol production, as indicated by lowered high and low diurnal cortisol slopes. However, no changes were found for cortisol awakening response or concentrations for single a.m. and p.m. time-points. MBIs also improved autonomic balance, assessed by heart rate variability coherence measures, but not blood pressure. Sympathetic nervous system reactivity as measured by salivary alpha amylase was also reduced following MBI. While aspects of immune function were also improved following MBIs, specifically, increased antibody response to a viral vaccine and reduced C-reactive protein concentrations, each of these outcomes were only assessed in a single study. CONCLUSION: Taken together, the findings suggest that MBIs are a promising avenue for intervention for improving physiological indices of stress. Our findings suggest that changes in daytime cortisol secretion and HRV coherence may be particularly influenced by MBIs. Future studies should aim to assess multiple physiological indices to confirm the current findings and further improve current understanding of which biological systems (and indices within these systems) show responses indicative of reduced stress due to MBI.