Objectives <p>This systematic review and meta-analysis aimed to evaluate the effect of nutrition education and counseling on the nutritional status of pregnant women in Ethiopia, to guide future public health efforts.</p> Study design <p>Systematic review and meta-analysis.</p> Method <p>Online databases, including PubMed, Scopus, Cochrane Library, Embase, and Google Scholar, were searched from 2014 up to December 2024. The review was conducted following PRISMA 2020 guidelines. Sub-group analysis, the I² test, funnel plot, and Egger's test were performed. A weighted mean difference was used to measure the outcome.</p> Result <p>Nine studies were included in the analysis. nutritional interventions significantly improved mid-upper arm circumference in the intervention group compared to the control group (mean difference = 0.75, 95% confidence interval: 0.37, 1.13). Community-based interventions showed greater effectiveness (mean difference = 1.03, 95% CI 0.66, 1.41), and interventions lasting 6&#xa0;months or more were more impactful (mean difference = 0.75, 95% CI 0.37, 1.13). Medium-intensity counseling also yielded better results than high-intensity counseling (mean difference = 0.76, 95% CI 0.28, 1.24). Individual-based interventions had a larger effect (mean difference = 0.98, 95% CI 0.17–1.78) compared to group-based ones (mean difference = 0.64, 95% CI 0.20–1.08). Theory-based counseling significantly improved mid-upper arm circumference (mean difference = 0.99, 95% CI 0.58, 1.40).</p> Conclusion <p>Nutrition education has a significant positive impact on the nutritional status of pregnant women, with the most effective results observed in community-based settings, extended interventions, medium-intensity counseling, individualized approaches, and theory-driven frameworks.</p> <p><i>PROSPERO registration number</i>: CRD42025638888.</p>