ObjectiveTo systematically evaluate the risk factors forpersistent cough after pneumonectomy and to provide a theoretical basis for the prevention of persistent cough after surgery. MethodsResearches on risk factors of persistent cough after pneumonectomy were retrieved from The Cochrane Library, Web of Science, Embase, PubMed, CBM, Wanfang, CNKI and VIP from inception to March 30, 2023. Two researchers screened the literature, extracted data, and conducted quality evaluation. Meta-analysis was performed using RevMan 5.3 software. ResultsSeventeen studies with a total of 3 698 patients were finally included. Meta-analysis results showed that: female [OR=3.10, 95%CI (1.99, 4.81), P<0.001], age<63 years [OR=1.72, 95%CI (1.33, 2.21), P<0.001], right lung surgery [OR=2.36, 95%CI(1.80, 3.10), P<0.001], lobectomy [OR=3.40, 95%CI (2.47, 4.68), P<0.001], upper lobectomy [OR=8.19, 95%CI (3.87, 17.36)], lymph node dissection [OR=3.59, 95%CI(2.72, 4.72), P<0.001], bronchial stump approach [OR=5.19, 95%CI(1.79, 16.07), P=0.002], and postoperative acid reflux [OR=6.24, 95%CI(3.27, 11.91), P<0.001] were all risk factors for persistent cough after pneumonectomy (P<0.05). Smoking history [OR=0.59, 95%CI(0.45, 0.77), , P<0.001] was a protective factor for postoperative cough. In addition, the quality of life score (LCQ-MC) of patients with cough after surgery was lower than that before surgery [MD=1.50, 95%CI(0.14,2.86), P=0.03]. ConclusionAvailable evidence suggests that female, age <63 years, right lung surgery, lobectomy, lymph node dissection, bronchial stump approach (suture clamp closure), and postoperative acid reflux are independent risk factors for persistent postoperative cough in patients undergoing lung resection, while smoking history may be a protective factor forpostoperative cough. It provides an evidence-based evidence for clinical medical staff to prevent and reduce postoperative persistent cough and improve the quality of life of patients in the future.