Aim <p>This systematic review and meta-analysis aimed to evaluate the effects of bariatric surgery on serum anti-Müllerian hormone (AMH) levels in women, highlighting potential implications for ovarian reserve and fertility management.</p> Methods <p>A systematic literature search was conducted in PubMed, Web of Science, Scopus, and Embase databases up to February 2025. The included studies were observational in design (cohort, case-control, cross-sectional) and provided quantitative pre- and post-operative AMH data. Quality assessment was performed using the Newcastle-Ottawa Scale, and data were analyzed using a random-effects meta-analysis.</p> Results <p>A total of 14 studies were included in the systematic review, with 591 participants contributing to the quantitative meta-analysis. The pooled results indicated that bariatric surgery did not significantly alter AMH levels overall (WMD = 0.05 ng/mL; 95% CI: −0.66, 0.75; <i>p</i> = 0.897), with substantial heterogeneity among effect estimates (I² = 93.9%, <i>p</i> &lt; 0.001). Subgroup analyses suggested significant AMH reductions in studies with baseline AMH &gt; 3 ng/mL, upper age limit ≤ 35 years, longer follow-up, retrospective design, smaller sample size, and South Asian populations, while a significant increase was observed in the fertile subgroup.</p> Conclusions <p>Bariatric surgery was not associated with a significant overall change in serum AMH levels. Findings suggest variable AMH responses across clinical and methodological contexts; however, given substantial heterogeneity and limited reproductive outcome data, these changes should be interpreted as dynamic endocrine biomarker responses rather than direct evidence of altered ovarian reserve or fertility potential.</p> Clinical trial number <p>Not applicable.</p> Graphical Abstract <p></p>