Objective <p>Determine the association between nun-nutritive sucking habits and anterior open bite in children.</p> Materials and methods <p>This systematic review and meta-analysis followed the PRISMA guidelines. A systematic searched of four databases was conducted through the end of February 2025. Study designs included observational and interventional studies. Nun-nutritive sucking habits was evaluated in three categories: (1) ever versus never; (2) longer periods versus shorter periods; (3) daily versus not daily. We considered anterior open bite as the outcome. Based on meta-analyses, the pooled adjusted odds ratio and its 95% confidence interval (95%CI) were calculated. We assessed heterogeneity with both Q-test and I-square. An assessment of publication bias was conducted using funnel plots and Egger's test.</p> Result <p>Thirty three studies were included in this meta-analysis. We found that NNSH (eg, pacifier sucking and digit sucking) was associated with varying risks of developing anterior open bite (<i>p</i> &lt; 0.01). Children with longer non-nutritive habits (for example, pacifier sucking and digit sucking) had a greater risk of developing anterior open bite than those with shorter habits. (<i>p</i> &lt; 0.05) In addition, daily pacifier user has been linked to increased risk of developing anterior open bites. [<i>N</i> = 3, OR = 10.22 (5.36,19.49), <i>p</i> &lt; 0.05].</p> Conclusion <p>In conclusion, prolonged and daily non-nutritive sucking habits, such as pacifier and digit sucking, are associated with a significantly increased risk of anterior open bite in children.</p> Clinical relevance <p>Thus, this study provides clinical support on early orthodontic treatment of AOB to inform preventative and management strategies.</p>