OBJECTIVE: Delayed facial nerve paralysis (DFNP) is a common complication after vestibular schwannoma surgery. Previous studies have focused on immediate facial nerve paralysis, and the risk factors for developing DFNP remain largely unclear. This study aimed to determine the incidence and risk factors of DFNP in patients after vestibular schwannoma resection. METHODS: Up to 8 October 2024, PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and China Science and Technology Journal Database were searched to extract the related data of DFNP. The pooled incidence of DFNP was calculated. Possible risk factors of DFNP were conducted to report the odds ratio/weighted mean difference (WMD), and their 95% confidence intervals (CIs). RESULTS: Twenty-seven studies were included, and 8656 patients underwent vestibular schwannoma resection. The incidence of DFNP in patients with vestibular schwannoma who underwent microsurgical resection was 12.3% (95% CI: 9.4%, 15.1%). The results of the influencing factor analysis showed that age (WMD: -4.28, 95% CI: -5.66, -2.91) and tumor size (WMD: 0.17, 95% CI: 0.01, 0.22) were related to the incidence of DFNP in patients after vestibular schwannoma resection. CONCLUSIONS: DFNP is a complication after vestibular schwannoma surgery that cannot be ignored. The risk factors (age and tumor size) of DFNP in patients after vestibular schwannoma surgery still need to be considered, and clinical management of high-risk groups should be strengthened in clinical practice.