Purpose <p>This systematic review aims to identify the factors influencing chemotherapy-induced oral mucositis in cancer patients.</p> Methods <p>A comprehensive literature search was conducted across PubMed, Web of Science, Embase, The Cochrane Library, VIP, Wanfang, CNKI, CBM, and CINAHL from the establishment of the databases to August 2024. Meta-analysis was performed using RevMan5.4 software, with odds ratios (OR) and 95% confidence intervals (CI) used to assess the risk factors. Methodological quality was assessed using the Newcastle–Ottawa Scale (NOS) and the evaluation criteria recommended by the Agency for Healthcare Research and Quality (AHRQ). The quality of evidence was graded using the GRADEpro GDT.</p> Results <p>The analysis included 10 studies with a total of 2365 patients. Six studies were of high quality, and four studies were of moderate quality. The results indicated that the following factors were associated with an increased risk of chemotherapy-induced oral mucositis (CIOM) in cancer patients: a history of oral disease, combination chemotherapy, smoking history, oral hygiene, and chemotherapy regimens containing 5-FU/methotrexate.</p> Conclusion <p>This meta-analysis identified several potential independent risk factors for CIOM in cancer patients. Early screening and timely intervention for patients with these risk factors are crucial for reducing the likelihood of CIOM and improving overall prognosis.</p>