Aflatoxin contamination in peanut oil poses significant health, agricultural, and environmental risks. This study assesses the effectiveness of advanced technologies and One Health strategies in mitigating these risks. Through systematic review and meta-analysis, we evaluate the effectiveness of integrated approaches. We conducted a systematic review and meta-analysis of studies from PubMed, Scopus, and Web of Science (September 2010-September 2024) on aflatoxin mitigation in peanut oil. We included studies involving agricultural, health, and environmental interventions, focusing on Aflasafe, ozonation, and One Health strategies. A random-effects meta-analysis was performed to calculate pooled effect sizes. Our review of 30 studies, including five meta-analyses, highlights that advanced mitigation methods like Aflasafe (90%, 95% CI: 85%-95%), Ozonation (85%, 95% CI: 70%-95%), and Biological Control (80%, 95% CI: 70%-90%) significantly reduce aflatoxin contamination in peanut oil. However, reduced efficacy was observed, with dexification found to be 58% (95% CI: 52%-64%) and a pooled effect size of 77% (95% CI: 67%-87%). One Health strategies also show substantial impact, with the highest effect size of 0.91 (95% CI: 0.81-1.00) through Aflasafe training, followed by integrated agricultural, environmental, and health education (0.70, 95% CI: 0.58-0.82) and health-sector risk awareness (0.68, 95% CI: 0.57-0.79), yielding a pooled effect size of 0.75 (95% CI: 0.70-0.80). This review highlights the effectiveness of advanced technologies and One Health strategies in reducing aflatoxin contamination in peanut oil. Combining Aflasafe, ozonation, and One Health approaches offers a promising strategy for both immediate control and sustainable management. Future research should prioritize cost-effective technologies and community-based interventions to enhance impact and scalability, especially in resource-limited settings.