The aims of this systematic review were to (i) determine the effectiveness of lay-led, group-based, self-management interventions in improving cognitive and physiological outcomes for minority ethnic participants residing in high-income countries and (ii) explore the relationship between cultural and structural adaptations to interventions and adherence to and effectiveness for minority ethnic populations. The Cochrane Library, Medline, CINAHL, EMBASE, ISI Web of Knowledge, Science Direct, Literatura Latino Americana em Ciências da Saúde (LILACS) and Sociological Abstracts were searched from inception or 1948 to July 2013. Study selection, data abstraction and quality assessment were carried out in duplicate. We included quantitative papers reporting results from randomised controlled trials, non-randomised controlled trials and pre-post studies written in English only. We included 28 studies with an overall sample of 6,087 participants. Interventions led to short-term improvements in participants' self-efficacy, cognitive symptom management, self-rated health and frequency of exercise. There were small but statistically significant improvements in clinical measures in HbA1c, BMI, weight loss and systolic blood pressure; however, they were not maintained in the medium-term post intervention. Lay-led, group-based, self-management interventions for minority ethnic populations in high-income countries can lead to short-term improvements for participants living with chronic diseases. Cultural and structural modifications perceived to influence outcome measures used ethnically matched lay people, delivered material in the target population's language, provided ethnically specific cultural food/activities/music and addressed emotional well-being. A set of criteria for reporting lay-led, culturally tailored inventions is presented that would make it easier to determine the effectiveness of interventions using meta-analysis.