IntroductionObesity is a global public health concern that is now on the rise, especially in low- and middle-income nations. Despite the fact that there are several studies reporting the prevalence of central obesity among adults in Ethiopia, there is a lack of a systematic review and meta-analysis synthesizing the existing observational studies. Therefore, this systematic review and meta-analysis aimed to determine the prevalence of central obesity and its associated factors in Ethiopia.MethodsOnline libraries such as PubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 16). Forest plots, Begg’s rank test, and Egger’s regression test were all used to check for publication bias. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region and study setting. In addition, the pooled odds ratio for related covariates was calculated.ResultsOut of 685 studies assessed, 20 met our criteria and were included in the study. A total of 12,603 people were included in the study. The prevalence of central obesity was estimated to be 37.31% [95% confidence interval (CI): 29.55–45.07]. According to subgroup analysis by study region and setting, the highest prevalence was observed in the Dire Dawa region (61.27%) and community-based studies (41.83%), respectively. Being a woman (AOR = 6.93; 95% CI: 3.02–10.85), having better socioeconomic class (AOR = 5.45; 95% CI: 0.56–10.34), being of age 55 and above (AOR = 5.23; 95% CI: 2.37–8.09), being physically inactive (AOR = 1.80; 95% CI: 1.37–2.24), being overweight (AOR = 4.00; 95% CI: 2.58–5.41), being obese (AOR = 6.82; 95% CI: 2.21–11.43), and having hypertension (AOR = 3.84; 95% CI: 1.29–6.40) were the factors associated with central obesity.ConclusionThe prevalence of central obesity was high in Ethiopia. Being a woman, having a higher socioeconomic class, being older, being physically inactive, being overweight or obese, and having hypertension were all associated. Therefore, it is vital for the government and health organizations to design and implement preventive measures like early detection, close monitoring, and positive reversal of central obesity in all patients and the general population. High-quality investigations on the prevalence of central obesity in the Ethiopian people are required to better understand the status of central obesity in Ethiopia.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022329234.