The aim of the current study was to perform a systematic review and meta-analysis to evaluate the relationship between step count and changes in blood pressure (BP). Studies involving healthy adults and an intervention in the form of brisk walking with a pedometer were included. Net changes in BP and step count in each trial were calculated and pooled. In addition, the pooled net changes of two categories (trials that achieved walking 10,000 steps a day and those that did not) were compared. A meta-regression analysis was performed to examine the relationship between net changes in BP and step count. Fourteen trials were analyzed. Pooled net changes in BP improved significantly (systolic BP, -3.1 mm Hg; diastolic BP, -1.6 mm Hg). When the trials were categorized depending on whether they achieved walking 10,000 steps a day, the pooled net change in systolic BP and diastolic BP did not differ significantly between both groups of subjects. The meta-regression analyses indicated that net change in systolic BP was significantly associated with an increased step count (e.g., systolic BP is expected to decrease approximately 4 mm Hg if increased step count by 2000 steps a day). However, net change in systolic BP was not associated with the step count in an intervention group following the intervention. At present, there is presumably no evidence that walking 10,000 steps a day lowers the BP to any marked degree. In order to reduce systolic BP by walking with a pedometer, one should be mindful of increasing one's step count.