Background <p>Gastric cancer (GC) incidence is low in the United States (US) and Canada but immigrants from regions with high incidence, such as Eastern Asia, Eastern Europe and Latin America, retain this increased risk. Reports suggest an increased incidence among Latinos living in the US and Canada, but the literature is mixed.</p> Methods <p>We conducted a systematic review and meta-analysis of population-based cancer registries to determine the GC risk among Latinos in the US or Canada. The primary outcome was GC incidence in Latinos compared to non-Hispanic Whites, expressed as incidence risk ratio (IRR) and 95%CI. We used a random-effects model to pool IRR. Secondary analyses evaluated differences in anatomical location (all sites vs. non-cardia), sex, and birthplace (foreign-born vs. US/Canada-born). Metaregression evaluated effect modifying variables. Sensitivity analyses estimated the effect of larger population-based registries in pooled effects.</p> Results <p>Thirteen studies were included (2 from Canada, and 11 from US) with &gt; 485,000 cancer cases diagnosed between 1988 and 2020. The overall IRR was 2.68 (95%CI, 2.17–3.19) with significant heterogeneity among studies. IRR increased to 3.55 (95%CI, 3.07–4.04) when analysis was restricted to non-cardia adenocarcinoma. Increased risk was similar among Latinos irrespective of sex. The IRR was higher among foreign-born vs. US/Canada-born Latinos, without reaching statistical significance. Country of residence, publication year and sample size did not have significant effect on metaregression. Significant heterogeneity was confirmed.</p> Conclusion <p>Latinos residing in US/Canada have 2–3 fold higher risk of GC compared to non-Hispanic Whites in the US/Canada and this risk persists for at least one generation. Targeted primary and secondary GC prevention programs appear warranted in this population.</p> Registration PROSPERO Number <p>[CRD42023429814].</p>