Objective: To assess the effects of fall prevention services initiated in the emergency department (ED) to support patients after discharge. Methods: A systematic review and meta-analysis were conducted. Analysis of pooled data used random-effects modelling with results presented as a risk ratio (RR). Results: Eleven studies were identified (n = 4,018). The proportion of older adults who fell did not differ between the intervention and control groups (RR 0.93; 95% CI, 0.82-1.06, I2 68%, P = 0.28). There was a significant (P = 0.01) reduction in the monthly rate of falling (RR 0.69; 95% CI, 0.52-0.91, I2 93%), fall-related injuries (RR 0.72; 95% CI, 0.59-0.88, I2 0%, P = 0.001), and hospital admissions (RR 0.76; 95% CI, 0.64-0.90, I2 0%, P = 0.002). Conclusions: ED fall prevention services did not significantly reduce the proportion of older adults who had future falls. However, multifactorial intervention significantly reduced fall-related injuries and hospital admissions with low heterogeneity.