Context <p>Prediabetes is a condition characterized by elevated blood glucose levels that are below the threshold for the diagnosis of diabetes. It is also an early indicator of long-term complications.</p> Objective <p>This systematic review and meta-analysis aimed to estimate the pooled prevalence of prediabetes and identify associated social factors among children and adolescents in India.</p> Evidence Acquisition <p>Observational studies published between 2008 and 2024 were included following the PRISMA 2020 guidelines. PubMed, Scopus, Web of Science, and Embase were searched for studies involving Indian participants aged 6–19&#xa0;years. Eligibility screening was performed in two stages by independent reviewers. The risk of bias was assessed using the Joanna Briggs Institute (JBI) tools. A random-effects model was used to compute the pooled prevalence.</p> Results <p>Fourteen studies (<i>n</i> = 48,454) were included. The pooled prevalence of prediabetes was 10% (95% CI 5–17%) with high heterogeneity (I² = 99.2%). The prevalence was higher in older adolescents (15–19 y: 23% vs. 10–14 y: 11%) and females (9% vs. males: 6%). Key social correlates included urban high socioeconomic status (linked to sedentary lifestyle and overnutrition), rural low socioeconomic status (linked to undernutrition and healthcare barriers), family history of diabetes, high sugar-sweetened beverage consumption, and physical inactivity. The prediction intervals (0–41%) indicated wide regional variability.</p> Conclusion <p>Prediabetes affects one in ten Indian youth, with the risk shaped by age, sex, and modifiable social determinants. Tailored public health interventions focusing on lifestyle modifications and early screening are critical to prevent progression to type 2 diabetes.</p>