BACKGROUND: Accumulating evidence indicates associations between ambient air pollution and Kawasaki disease (KD), but the results remain inconsistent. OBJECTIVES: This systematic review and meta-analysis aimed to comprehensively summarize the current evidence on the effects of ambient air pollutants on KD. METHODS: The PubMed, Web of Science, Embase, and Scopus databases were searched up to January 18, 2025 for studies investigating the effects of ambient air pollution on KD. A fixed- or random-effects model was used to calculate pooled ORs with 95% CIs for an increase in ambient air pollutant concentration of 10 μg/m RESULTS: Thirteen studies with 124,857 participants were included. Seven studies were at high risk of bias. The meta-analysis revealed an increased risk of KD after short-term postnatal exposure to PM CONCLUSIONS: Both prenatal and postnatal exposure to several ambient pollutants are associated with the risk of KD.