This systematic review includes a search of the literature covering the period 2005-2021 to understand what preventative teaching approaches and interventions have been developed in higher education to reduce music performance anxiety (MPA). The focus here is on identifying interventions that are applicable to higher education teaching practice, in an attempt to support music educators to reduce the negative effects of MPA, and, by so doing, support better learning outcomes. A systematic review of the literature on MPA (2005-2021) was undertaken to explore the teaching strategies that are used to help students in higher education. The researchers performed independent assessments of the literature based on the inclusion criteria. Discrepancies between the two reviewers were resolved through discussion. Each of the articles that met the research conditions was classified using four treatment modalities: cognitive interventions, behavioural interventions, pharmacological treatment and complementary. The initial scoping resulted in a total of 116 research articles. This was reduced to 18 articles that fully met the inclusion criteria. There is a wealth of literature exploring MPA; however, very few teaching approaches or interventions have been found that can easily be embedded in music education. The findings indicate that interventions deriving from promising reactive treatment have been developed, but that these are rarely generalisable to typical teaching practice.