Aim <p>The study aims to investigate the global prevalence of text neck syndrome (TNS) among university students through a systematic review and meta-analysis.</p> Methods <p>In the initial phase, cross-sectional studies reporting TNS prevalence among university students were systematically retrieved from multiple electronic databases, including Medline, Scopus, PubMed, ScienceDirect, Web of Science, and Google Scholar, without language or date restrictions. Study selection adhered to the PRISMA guidelines for systematic reviews and meta-analyses.</p> Results <p>The pooled prevalence of TNS among university students was 60.8%, with a high heterogeneity rate (I²). Egger’s (<i>p</i> = 0.949) and Begg’s (<i>p</i> = 0.548) tests indicated no evidence of publication bias or minor study effects. Stratified by gender, the pooled prevalence of TNS was 64.73% among female students (I² = high; Egger’s <i>p</i> = 0.933, Begg’s <i>p</i> = 1.0) and 37.02% among male students (I² = low). Additionally, the pooled prevalence of the neck disability index (NDI) was 57.74% (I² = high), with mild, moderate, and severe cases accounting for 37.53%, 17.69%, and 2.90% respectively. The prevalence of neck pain was 46.17%, while nomophobia (defined as "the irrational fear of being without a mobile phone") was found to be highly prevalent at 79.03%.</p> Conclusion <p>These findings emphasized the urgent need for targeted preventive measures, awareness campaigns, and ergonomic interventions to mitigate the adverse health impacts of TNS and associated conditions among university students.</p>