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Reviews focused on the ketogenic diet (KD) based on the increase in fat-free mass (FFM) have been carried out with pathological populations or, failing that, without population differentiation. The aim of this review and meta-analysis was to verify whether a ketogenic diet without programmed energy restriction generates increases in fat-free mass (FFM) in resistance-trained participants. We evaluated the effect of the ketogenic diet, in conjunction with resistance training, on fat-free mass in trained participants. Boolean algorithms from various databases (PubMed, Scopus. and Web of Science) were used, and a total of five studies were located that related to both ketogenic diets and resistance-trained participants. In all, 111 athletes or resistance-trained participants (87 male and 24 female) were evaluated in the studies analyzed. We found no significant differences between groups in the FFM variables, and more research is needed to perform studies with similar ketogenic diets and control diet interventions. Ketogenic diets, taking into account the possible side effects, can be an alternative for increasing muscle mass as long as energy surplus is generated; however, their application for eight weeks or more without interruption does not seem to be the best option due to the satiety and lack of adherence generated.