Bovine mastitis remains a major prevalent disease in cattle and places a significant economic burden on the global dairy industry. The goal of this systematic review and meta-analysis was to examine the overall prevalence of mastitis and its associated risk factors among dairy cows. Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, and other sources from Google Engine and University Library Databases. “Prevalence,” “bovine mastitis,” “clinical mastitis,” “subclinical mastitis,” “associated factors,” “dairy cows,” and “Ethiopia” were search terms used for this study. For critical appraisal, PRISMA 2009 was applied. Heterogeneity and publication bias were evaluated using Cochran's Q , inverse variance ( I 2 ), and funnel plot asymmetry tests. A random-effects model was used to calculate the pooled burden of mastitis and its associated factors among dairy cows, along with the parallel odds ratio (OR) and 95% confidence interval (CI). A total of 6438 dairy cows were included in the 17 eligible studies for this meta-analysis. The overall pooled prevalence of mastitis among dairy cows in Ethiopia was 43.60% (95% CI: 34.71, 52.49), of which 12.59% (95% CI: 7.18, 18.00) and 32.21% (95% CI: 24.68, 39.74) were clinical and subclinical cases, respectively. Of the regions, the highest and lowest pooled prevalence estimates of mastitis among dairy cows were 49.90% (95% CI: 31.77, 68.03) and 25.09% (95% CI: 3.86, 46.32) in the Oromia and Amhara regions, respectively. The highest pooled prevalence estimate in the study period was recorded between 2017 and 2022, with a pooled prevalence estimate of 46.83% (95% CI: 35.68, 57.97), followed by the study period from 2005 to 2016, with a pooled prevalence estimate of 39.97% (95% CI: 25.50, 54.44). Gram-positive bacteria (84.70%) were the most prevalent mastitis-causing agents compared with Gram-negative bacteria (15.30%). Breed (AOR: 2.17, 95% CI: 1.44, 2.90), lactation stage (AOR: 1.59, 95% CI: 1.04, 2.15), parity (AOR: 3.31, 95% CI: 1.69, 4.94), history of mastitis (AOR: 3.56, 95% CI: 2.40, 4.71), floor type (AOR: 1.59, 95% CI: −0.16, 3.34), and teat injury (AOR: 6.98, 95% CI: 0.33, 13.64) were factors significantly associated with mastitis among dairy cows in Ethiopia. Early diagnosis and proper medication, as well as implementing appropriate prevention and control measures, are necessary for the management of mastitis in dairy cows.