Study Design <p>Systematic review and meta-analysis.</p> Objectives <p>To assess the risk of type 2 diabetes mellitus (T2DM) in individuals with spinal cord injury (SCI) and explore factors contributing to this variability.</p> Setting <p>The studies included in this review were conducted across multiple countries, offering a diverse representation of global prevalence.</p> Methods <p>A systematic search was conducted. A random-effects meta-analysis estimated the pooled prevalence and odds ratio of data extracted from eligible studies. Meta-regression and subgroup analysis were performed to assess the impact of covariates and study variables.</p> Results <p>28 studies were included, with a total of 99,916 individuals. The pooled prevalence of T2DM in the SCI population was 14.2% (95% CI: 10.3–18%). Moreover, a meta-analysis of the odds ratio (OR) demonstrates the pooled random‐effects of 2.3 (95% CI: 1.5–3.5). Geographical differences were a key factor, with higher prevalence reported in the USA (18.9%) compared to other regions (8.2%) (p = 0.002). Age was also positively associated with T2DM prevalence (p = 0.007), with a significant rise observed in individuals over 50. Additionally, a significantly higher pooled prevalence of T2DM among the veteran population compared to non-veterans has been revealed (21 and 10.3%, respectively).</p> Conclusion <p>Our findings confirm a significantly greater likelihood of T2DM in SCI individuals and a higher burden of T2DM compared to the general population. The correlation between aging and T2DM prevalence emphasizes the necessity for early screening in older SCI individuals.</p> <p></p>