<p>Cosmetic products frequently contain synthetic toxic compounds that may pose health risks. However, no prior comprehensive study has synthesized evidence on the prevalence of cosmetic use, associated adverse health events, and their determinants in Ethiopia. This systematic review and meta-analysis aimed to estimate the pooled percentage of cosmetic use, adverse events, and associated factors in Ethiopia. Relevant studies were retrieved from PubMed, ScienceDirect, Springer Nature, and Google Scholar. The data were analyzed using Stata 17, with heterogeneity assessed by the I² statistic and publication bias evaluated through Egger’s regression test and funnel plots. The pooled prevalence of cosmetic users in Ethiopia was 93%, while 47% of users reported adverse health events from six studies. Significant predictors of adverse outcomes included reliance on traditional cosmetics, unsafe sources of products, adding water or saliva before use, frequent application, and sharing of cosmetics. Given the widespread use and substantial burden of adverse reactions, targeted interventions are urgently needed. Public health authorities should strengthen awareness programs, regulate the quality and distribution of cosmetics, and promote safer consumer practices to minimize health risks in Ethiopia.</p>