To systematically evaluate the incidence and risk factors of cerebral hyperperfusion syndrome (CHS) after carotid artery stenting. Methods: We retrieved risk factors from eight major databases for case-control studies and cross-sectional studies of CHS after carotid artery stenting in Jan 26, 2023, including Pubmed, Cochrane Library, Embase, Web of Science, China Biomedical Literature Database, China Knowledge Network, Wanfang Data, and Chinese Science and Technology Journal Database. The meta-analysis was performed using R4.2.1 and Review Manager 5.3. Results: A total of 3313 samples were searched and 14 studies were included. Meta-analysis results showed that the incidence of CHS after carotid artery stenting was 10.0% (95% CI 6%-14% ). History of diabetes [OR=2.54, 95% CI(1.64, 3.95), P<0.0001], severe stenosis [OR=20.69, 95% CI(1.15, 370.72), P=0.04], preoperative cerebrovascular reactivity [OR=24.53, 95% CI(16.51, 32.55), P< 0.00001] and rear circulation bracket [OR=2.96, 95% CI(1.31, 6.68), P=0.009] were risk factors for CHS after carotid artery stenting. Conclusion: The meta-analysis showed a higher incidence of CHS after carotid artery stenting. Previous history of diabetes mellitus, severe stenosis, preoperative cerebrovascular reactivity and rear circulation bracket are important risk factors for CHS after carotid artery stenting. These factors should be fully considered in perioperative care for these patient groups.