Objective To systematically review the factors for unplanned extubation of endotracheal intubation in critically ill children. Methods CNKI，WanFang Data，VIP，SinoMed，PubMed，Embase，Cochrane Library and Web of Science databases were electronically searched to collect relevant cohort，case-control or cross-sectional studies on factors of unplanned extubation of endotracheal intubation in critically ill children from inception to May 2024. Two researchers independently screened literature，extracted data and assessed the quality of included studies. Meta-analysis was then performed by using RevMan 5.3. Results A total of 15 articles were included，involving 6 cohort studies，4 case-control studies and 5 cross-sectional studies. The studies included a total of 54 397 ill children，with a total of 2 401 unplanned extubation. The risk factors were age ≤2（OR=1.32） ， male（OR=1.34） ， underweight（OR=1.56） ， prematurity（OR=1.63） ， secretions（OR=7.27） ， sedation（OR=3.82）， agitation（OR=1.88），mechanical ventilation duration（OR=1.03） ， inadequate fixation（OR=2.12） ， ventilator weaning phase（OR=2.23） ， tube with cuff（OR=0.47） ， nurse/patient ratio（OR=2.66） ， work shift（OR=2.85）and nurse experience（OR=2.29）. Conclusion Medical staff can make a dynamic assessment according to the influencing factors and take targeted preventive measures to minimize the incidence of unplanned extubation of endotracheal intubation in critically ill children.