Objectives of this study were to critically review randomized controlled trials, evaluate the effectiveness of supplementation with biotin on milk yield and composition and hoof health in lactating dairy cows, explore sources of heterogeneity among studies, and evaluate publication bias. Quantitative assessments can increase the statistical power with which we study the effect of treatments, such as biotin, on outcomes. A total of 9 papers, with 6 production and 3 hoof health studies, met the eligibility criteria for meta-analysis. Eight studies evaluated various hoof lesions in biotin-supplemented cows that did not meet the inclusion criteria. Eleven comparisons were made of milk production responses to biotin treatment. Data extracted included the number of cows in control and treatment groups, measures of variance of responses (standard error or standard deviation) and P-values. Other data obtained included the duration of treatment before and after calving, parity, breed of cow, type and dose of biotin, delivery method of supplementation, and types of diets. Biotin increased milk production by 1.29 kg per head per day (95% confidence interval=0.35 to 2.18 kg) with no evidence of heterogeneity (I(2)=0.0%). Treatment did not affect milk fat or protein percentages, and a trend to increase fat and protein yields was observed. Milk production and composition results were not influenced by duration of treatment before calving, parity, or diet type. Assessment of biotin supplementation on hoof health indicated that more studies had improved rather than negative or neutral outcomes. The effect of biotin treatment on milk production was relatively large and the effects on fat and protein yields, although not significant, were consistent in direction and magnitude with the milk response. The hoof health responses to biotin should encourage further studies to more effectively define the nature of these responses using consistent criteria for examination of hoof conditions and lameness.