Drought will increasingly threaten forest ecosystems worldwide. Understanding how competition influences tree growth response to drought is essential for forest management aiming at climate change adaptation. However, published results from individual case studies are heterogeneous and sometimes contradictory. We reviewed 166 cases from the peer-reviewed literature to assess the influence of stand-level competition on tree growth response to drought. We monitored five indicators of tree growth response: mean sensitivity (inter-annual tree ring width variability); association between inter-annual growth variability and water availability; resistance; recovery; and resilience to drought. Vote counting did not indicate a consistent effect of competition on mean sensitivity. Conversely, higher competition for resources strengthened the association between water availability and inter-annual growth rates. Meta-analysis showed that higher competition reduced resistance (p < 0.001) and improved recovery (p < 0.05), but did not consistently affect resilience. Species, site and stand characteristics, and drought intensity were insignificant or poor predictors for the large variability among the investigated cases. Our review and meta-analysis show that competition does not affect the response of tree growth to drought in a unidirectional and universal way. Although density reduction (thinning) can alleviate growth declines during drought, the effects on growth after stress are uncertain. The large variability among investigated cases suggests that local-scale processes play a crucial role in determining such responses and should be explicitly evaluated and integrated into specific strategies for adaptation of forests to climate change.