This systematic review and meta-analysis examines the differences in blood pressure (BP) levels between Sub-Saharan Africans (SSA), South Asians (SA), and Europeans (EU) living in Europe. The study aims to assess gender-specific absolute differences in office systolic (SBP) and diastolic (DBP) BP levels among these groups. Twenty-one studies involving 9,070 SSA, 18,421 SA, and 130,380 EU participants were included. Compared to EU, SSA had higher SBP (3.38 mmHg, 95% CI 1.28 to 5.48 mmHg) and DBP (3.29 mmHg, 95% CI 1.80 to 4.78 mmHg) in both men and women. SA had lower SBP than EU (-4.57 mmHg, 95% CI -6.20 to -2.93 mmHg in men; -2.97 mmHg, 95% CI -5.45 to -0.49 mmHg in women) but similar DBP values. Meta-analysis by subgroup showed that SA from countries with Islam as the main religion had lower SBP and DBP than EU. Multivariate meta-regression analyses indicated that the difference in SBP between minorities and EU was influenced by panethnicity and diabetes prevalence. The study concludes that the higher BP in SSA is maintained over decades, suggesting limited efficacy of prevention strategies in this group. The lower BP in Muslim populations suggests untapped lifestyle and behavioral advantages in hypertension development. The additive effect of diabetes emphasizes the need for new strategies to control hypertension in high-prevalence groups.This systematic review and meta-analysis examines the differences in blood pressure (BP) levels between Sub-Saharan Africans (SSA), South Asians (SA), and Europeans (EU) living in Europe. The study aims to assess gender-specific absolute differences in office systolic (SBP) and diastolic (DBP) BP levels among these groups. Twenty-one studies involving 9,070 SSA, 18,421 SA, and 130,380 EU participants were included. Compared to EU, SSA had higher SBP (3.38 mmHg, 95% CI 1.28 to 5.48 mmHg) and DBP (3.29 mmHg, 95% CI 1.80 to 4.78 mmHg) in both men and women. SA had lower SBP than EU (-4.57 mmHg, 95% CI -6.20 to -2.93 mmHg in men; -2.97 mmHg, 95% CI -5.45 to -0.49 mmHg in women) but similar DBP values. Meta-analysis by subgroup showed that SA from countries with Islam as the main religion had lower SBP and DBP than EU. Multivariate meta-regression analyses indicated that the difference in SBP between minorities and EU was influenced by panethnicity and diabetes prevalence. The study concludes that the higher BP in SSA is maintained over decades, suggesting limited efficacy of prevention strategies in this group. The lower BP in Muslim populations suggests untapped lifestyle and behavioral advantages in hypertension development. The additive effect of diabetes emphasizes the need for new strategies to control hypertension in high-prevalence groups.