OBJECTIVE: To make healthcare programmes more patient-centred and efficient in light of limited resources, it is crucial to ensure patient satisfaction. There is limited information on the overall level of satisfaction with Human Immunodeficiency Virus/ Acquired Immune deficiency syndromes (HIV/AIDS) treatment and care services in Ethiopia. This meta-analysis aimed to generate a nationwide pooled estimate of the level of satisfaction with HIV/AIDS and associated factors by combining data from primary studies to provide a general overview of the effect across the country, aiming to informed policy decisions. DESIGN: Systematic review and meta-analysis. DATA SOURCE: PubMed, Scopus, Hinari, African journals online and Google Scholar were used to locate published studies. ELIGIBILITY CRITERIA: Observational studies assessing the level of satisfaction with HIV/AIDS care and treatment services and its associated factors among adult people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia were included. DATA EXTRACTION AND SYNTHESIS: Two authors extracted the data using a pre-established data extraction format and exported it to Stata V.17 for analysis. The Cochran-Q and I RESULTS: 24 studies were included. The pooled level of satisfaction with HIV/AIDS treatment and care services in Ethiopia was 69.7% (95% CI 63.8, 75.5%) with a significant level of heterogeneity (I CONCLUSIONS: More than two-thirds were satisfied with HIV/AIDS treatment and care services in Ethiopia. The findings showed the presence of regional differences in satisfaction with HIV/AIDS treatment and care services. The finding suggested that policy-makers and healthcare administrators should focus on empowering patients to make treatment decisions, pay attention to areas of service provision that affect HIV/AIDS care and treatment services and make strategic plans for effective and better-quality services. PROSPERO REGISTRATION NUMBER: CRD42023438589.