Background <p>The high incidence of dysphagia in patients after oesophageal cancer surgery significantly impacts prognosis and rehabilitation. We aimed to summarize the risk factors for dysphagia in patients with oesophageal cancer through a meta-analysis and systematic review.</p> Methods <p>We comprehensively searched the PubMed, EBASE, Web of Science, and Cochrane databases to retrieve articles published up to August 2024 for research on dysphagia after oesophagectomy patients. Relevant data were extracted and evaluated using fixed-effects or random-effects models to aggregate the effect sizes.</p> Results <p>The final review included sixteen studies. The meta-analyses, revealed that seven factors were significantly associated with the onset of dysphagia. The pooled age showed an odds ratio (OR) of 1.06 (95% confidence interval [CI] 1.02–1.1) in univariate analysis and 1.07 (95% CI 1.05–1.09) in multivariate analysis. Body mass index demonstrated an OR of 0.96 (95% CI 0.92–0.99), and tumour location showed an OR of 2.61 (95% CI 1.01–6.77). Sarcopenia demonstrated an OR of 1.69 (95% CI 1.23–2.32) in univariate analysis and 3.42 (95% CI 1.76–6.66) in multivariate analysis. Recurrent laryngeal nerve palsy demonstrated an OR of 3.03 (95% CI 2.18–4.2) in univariate analysis and 3.63 (95% CI 2.46–5.35) in multivariate analysis. Prognostic Nutritional Index demonstrated an OR of 1.21 (95% CI 1.02–1.43), and maximum anterior displacement of the hyoid showed a standardized mean difference of − 0.74 (95% CI −1.17 to −0.31).</p> Conclusions <p>Our meta-analysis results demonstrated that age, body mass index, sarcopenia, tumour location, prognostic nutritional index, maximum anterior displacement of the hyoid, and recurrent laryngeal nerve palsy were associated with dysphagia and revealed multiple clinicopathological factors that correlate with dysphagia in patients undergoing oesophagectomy.</p>