Objectives <p>The suturing technique used for ileostomy creation may influence the severity of peristomal adhesion; however, no meta-analysis on this topic has been reported to date. The aim of this study was to evaluate whether the one-stitch method (OM) for ileostomy construction can reduce the degree of peristomal adhesion.</p> Methods <p>A systematic search was conducted in major databases, including PubMed, Cochrane Library, Web of Science, and Embase, covering the period from database inception to January 1, 2026. Studies comparing the one-stitch ileostomy technique with traditional method (TM) for ileostomy were included. The included studies were primarily observational studies, along with a randomized controlled trial (RCT). Meta-analysis was performed using RevMan 5.3 software.</p> Results <p>A total of 6 studies involving 1167 patients were included. The meta-analysis showed that, compared with TM for ileostomy, the OM significantly reduced moderate (OR = 0.58, 95% CI 0.38–0.88, <i>P</i> &lt; 0.05, <i>I</i>^<i>2</i> = 0%) and severe (OR = 0.38, 95% CI 0.21–0.67, <i>P</i> &lt; 0.05, <i>I</i>^<i>2</i> = 0%) peristomal adhesion. In addition, the OM technique suggested a possible association with shorter total operative time and shorter stoma reversal time. The overall incidence of stoma-related complications was lower in the OM group than in the TM group (OR = 0.58, 95% CI 0.42–0.80, <i>P</i> &lt; 0.05, I² = 48%). However, no statistically significant differences were observed between the two groups in terms of specific types of stoma-related complications, including stoma retraction, stoma-related dermatitis, mucocutaneous separation, stoma prolapse, parastomal hernia, stoma bleeding, stoma necrosis, and stoma stenosis.</p> Conclusions <p>The OM appears feasible for ileostomy construction, with the potential to alleviate peristomal adhesion and facilitate stoma reversal; however, the evidence remains preliminary.</p>