Music-supported therapy (MST) has emerged as a promising adjunctive intervention in stroke rehabilitation, addressing both physiological and psychological aspects of recovery. This systematic review evaluates the efficacy of MST in enhancing physiological and psychological states in stroke patients, synthesizing findings from 18 studies published between 2012 and 2022. The reviewed studies include randomized controlled trials, prospective studies, and meta-analyses. Quantitative analyses consistently demonstrated improvements in motor function, cognitive abilities, emotional well-being, and quality of life among stroke patients receiving MST interventions. Mechanistically, MST leverages neural plasticity, rhythmic auditory stimulation, cognitive engagement, and emotional modulation to facilitate recovery. These findings suggest that MST not only aids in physical rehabilitation but also promotes cognitive and emotional health, offering a holistic approach to stroke recovery. Qualitative insights from the studies highlighted the motivational and enjoyable aspects of music therapy, which contribute to a more engaging and positive rehabilitation experience for patients. The enjoyment and motivation derived from music therapy were noted as significant factors in sustaining patient engagement and participation in rehabilitation programs. Despite these promising outcomes, the review identified limitations such as the heterogeneity of interventions and small sample sizes. These factors pose challenges in standardizing MST protocols and fully validating its efficacy across diverse patient populations. To address these limitations, future research should focus on conducting large-scale randomized controlled trials with standardized protocols and long-term follow-up assessments. In conclusion, MST represents a valuable addition to conventional stroke rehabilitation strategies, offering multifaceted benefits that encompass physical, cognitive, and emotional domains. As the evidence base for MST continues to grow, it has the potential to enhance outcomes and quality of life for stroke survivors. MST stands to become a cornerstone of comprehensive stroke rehabilitation programs, providing a well-rounded approach to recovery.