OBJECTIVE The purpose of this systematic review was to evaluate the current evidence base for whole-body vibration as a treatment for low back pain (LBP). CONCLUSIONS Whole-body vibration through occupational exposure has previously been recognized as an aetiological factor in LBP. Previous studies have identified whole-body vibration (WBV) as a cause of LBP in various sitting-based occupations that involve machinery and repetitive vibration. In the last decade, however, WBV has been advocated as a safe and effective treatment for LBP. Despite the growing popularity of WBV in clinical practice, this systematic review of the literature identified only two studies that investigated the effectiveness of WBV as a treatment option for LBP, and an assessment of the quality of these studies demonstrated several methodological problems that may have biased their findings. While there is emerging evidence for the effectiveness of WBV in treating some medical conditions, the evidence for WBV as a treatment for LBP remains equivocal. CONCLUSIONS Based on the current body of evidence, routine use of WBV to treat LBP should be undertaken with caution. Further rigorous research designed to investigate the effectiveness of WBV as a safe and high-quality treatment for LBP is required.