Introduction <p>A considerable body of research has examined the association between perceived stress and mobile phone addiction among adolescents, but findings have been inconsistent. This meta-analysis aims to clarify the strength of the relationship between perceived stress and mobile phone addiction in adolescents and to identify potential moderating factors influencing this association.</p> Methods <p>A comprehensive systematic search was conducted across thirteen databases, namely, PubMed, Web of Science, PsycINFO, Embase, Cochrane, Scopus, ProQuest, CINAHL, MEDLINE, SinoMed, CNKI, WANFANG, and VIP, spanning from their inception to February 15, 2025. Two independent reviewers were responsible for the screening of studies, extraction of data, and assessment of the quality of the included studies. Data analysis was performed using the statistical software STATA version 18.0.</p> Results <p>Forty-five studies involving 34,558 adolescents were included. The results showed a strong positive association between perceived stress and mobile phone addiction (<i>r</i> = 0.40, 95% CI: 0.35—0.44, <i>p</i> &lt; 0.001,<i> I</i>^<i>2</i> = 94.2%). Additionally, region and the measurement tools used for mobile phone addiction were found to moderate this relationship, while publication year, research design, gender, grade, and the perceived stress measurement tools did not have moderating effects.</p> Conclusions <p>This study demonstrates that reducing stress may alleviate adolescents' tendency toward mobile phone addiction. In the future, measures aimed at preventing and alleviating mobile phone addiction should place significant emphasis on the stress levels of adolescents.</p>