Background: Stroke remains a major global health challenge, ranking as the second leading cause of death and the third leading cause of combined death and disability worldwide. The burden of stroke continues to rise, particularly in low- and middle-income countries, with significant impacts on mortality, disability, and healthcare costs. Innovative rehabilitation strategies are essential to address the growing need for effective post-stroke recovery. Introduction: Stroke is characterized by a sudden disruption of blood flow to the brain, resulting in neurological impairments. The global burden has increased substantially, with a 70% rise in incident strokes and an 86% increase in prevalence from 1990 to 2021. Traditional rehabilitation faces limitations in engagement and outcomes, prompting exploration of technologies like virtual reality (VR) to enhance recovery, especially for balance and gait in post-ischemic stroke patients. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted, comparing VR-based interventions with conventional rehabilitation in post-stroke patients. Data extracted included patient demographics, stroke characteristics, VR intervention specifics, control interventions, and validated outcome measures for motor function, balance, gait, cognition, and activities of daily living (ADLs). Results: The literature consistently demonstrates that VR is a valuable adjunct to traditional rehabilitation, significantly improving balance, gait, and patient motivation in post-ischemic stroke populations. Fully immersive VR, especially when combined with conventional therapy, enhances motor recovery and functional outcomes. Conclusion: VR is a promising adjunct therapy for improving balance and gait in post-ischemic stroke patients, offering engaging environments and real-time feedback that enhance motor relearning and motivation. Although not universally superior to conventional therapy, VR provides meaningful benefits when customized and integrated with standard care.