Aim: Youth at clinical high risk for psychosis often demonstrate significant negative symptoms and poor functioning. However, the magnitude and direction of the relationship between the two remains unknown. Therefore, the objective of this systematic review was to summarize the relationship between negative symptoms and functioning in CHR samples.Method: Electronic databases Embase, EBM, MEDLINE, CINAHL, and PsycINFO were searched from inception. Studies were selected if they included any study that reported a relationship between negative symptoms and functioning in youth at CHR. The correlation coefficient r was converted to Cohen's d and all random effects meta-analyses were performed using the transformed values.Results: Forty-one studies met the inclusion criteria, including a total of 4,574 clinical high risk for psychosis individuals. Negative symptom total scores were significantly associated with poorer global functioning (d, −1.40; 95% CI= −1.82, −0.98; I 2 =79.4%; P<0.001, 9 studies, N=782), social functioning (d, −1.10; 95% CI= −1.27, −0.93; I 2 =10.40%; P<0.001, 12 studies, N=811), and role functioning (d, −0.96; 95% CI= −1.17, −0.76; I 2 =41.1%; P<0.001, 9 studies, N=881).In addition, negative symptoms were consistently associated with poor premorbid functioning. When examining negative symptom domains; avolition, anhedonia, and blunted affect were each significantly and independently associated with poorer social functioning and role functioning. In terms of prediction models, negative symptoms contributed to the prediction of lower functioning across multiple studies. Conclusion:This meta-analysis demonstrated a consistent and strong relationship between negative symptoms and functioning in youth at clinical high risk for psychosis.