Background The external movement loads imposed on players during competitive team sports are commonly measured using global positioning system devices. Information gleaned from analyses is employed to calibrate physical conditioning and injury prevention strategies with the external loads imposed during match play. Intense accelerations and decelerations are considered particularly important indicators of external load. However, to date, no prior meta-analysis has compared high and very high intensity acceleration and deceleration demands in elite team sports during competitive match play. Objective The objective of this systematic review and meta-analysis was to quantify and compare high and very high intensity acceleration vs. deceleration demands occurring during competitive match play in elite team sport contexts. Methods A systematic review of four electronic databases (CINAHL, MEDLINE, SPORTDiscus, Web of Science) was conducted to identify peer-reviewed articles published between January 2010 and April 2018 that had reported higher intensity (> 2.5 m•s −2) accelerations and decelerations concurrently in elite team sports competitive match play. A Boolean search phrase was developed using key words synonymous to team sports (population), acceleration and deceleration (comparators) and match play (outcome). Articles only eligible for meta-analysis were those that reported either or both high (> 2.5 m•s −2) and very high (> 3.5 m•s −2) intensity accelerations and decelerations concurrently using global positioning system devices (sampling rate: ≥ 5 Hz) during elite able-bodied (mean age: ≥ 18 years) team sports competitive match play (match time: ≥ 75%). Separate inverse random-effects meta-analyses were conducted to compare: (1) standardised mean differences (SMDs) in the frequency of high and very high intensity accelerations and decelerations occurring during match play, and (2) SMDs of temporal changes in high and very high intensity accelerations and decelerations across first and second half periods of match play. Using recent guidelines recommended for the collection, processing and reporting of global positioning system data, a checklist was produced to help inform a judgement about the methodological limitations (risk of detection bias) aligned to 'data collection', 'data processing' and 'normative profile' for each eligible study. For each study, each outcome was rated as either 'low', 'unclear' or 'high' risk of bias. Results A total of 19 studies met the eligibility criteria, comprising seven team sports including American Football (n = 1), Australian Football (n = 2), hockey (n = 1), rugby league (n = 4), rugby sevens (n = 3), rugby union (n = 2) and soccer (n = 6) with a total of 469 male participants (mean age: 18-29 years). Analysis showed only American Football reported a greater frequency of high (SMD = 1.26; 95% confidence interval [CI] 1.06-1.43) and very high (SMD = 0.19; 95% CI − 0.42 to 0.80) intensity accelerations compared to decelerations. All other sports had a greater frequency of h...