BackgroundThe understanding of the prevalence and early predictive factors of scoliosis in children and adolescents is limited, which poses challenges to developing preventative strategies. This systematic review and meta-analysis aimed to clarify the prevalence and predictors of scoliosis among children and adolescents.MethodsWe conducted a comprehensive search in PubMed, Cochrane, Embase, and Web of Science through October 2023. The quality of included studies was evaluated using the Joanna Briggs Institute scale or the Newcastle-Ottawa Scale. Subgroup analyses were performed to examine different types of scoliosis and specific demographic groups.ResultsFrom 32 studies encompassing 55,635,351 children and adolescents, we identified 284,114 cases of scoliosis, resulting in a prevalence rate of 3.1% (95% CI: 1.5%–5.2%). This rate varied by gender, degrees of scoliosis severity, and between idiopathic vs. congenital forms. Notable predictors included gender, age, Body Mass Index (BMI), race, environmental factors, and lifestyle choices.ConclusionScoliosis is a significant condition affecting a minority of children and adolescents, particularly adolescent girls and individuals who are overweight. It is recommended that guardians and schools enhance educational efforts towards its prevention.Systematic Review Registrationhttps://www.crd.york.ac.uk/, Identifier CRD42023476498.