<p>Introduction: Retinal vascular occlusion (RVO), a common eye condition, has been hypothesized as a potential indicator of neurodegenerative risk. This systematic review and meta-analysis aimed to quantitatively assess the association between RVO and the subsequent development of dementia. Methods: A comprehensive search of major databases was conducted to identify cohort studies investigating the association between RVO and dementia. Data on hazard ratios (HRs) and odds ratios (ORs) for all-cause dementia, Alzheimer’s disease, and vascular dementia were extracted. Pooled effect estimates were calculated using a random-effects model. Results: Six cohort studies with a pooled sample size of 4,638,720 participants were included. The pooled odds ratio for developing dementia in patients with RVO was 1.54 (95% CI (0.95, 2.47), <i>p</i> = 0.08; I² = 62%). The pooled hazard ratio for all-cause dementia was 1.04 (95% CI (0.92, 1.16), <i>p</i> = 0.56; I² = 93%). For Alzheimer’s disease, the pooled HR was 1.01 (95% CI (0.91, 1.13), <i>p</i> = 0.83; I² = 78%). Notably, the pooled hazard ratio for vascular dementia showed a statistically significant increased risk in patients with RVO at 1.15 (95% CI (1.04, 1.28), <i>p</i> = 0.008; I² = 40%). Conclusion: This meta-analysis suggests a significant association between RVO and increased vascular dementia risk, highlighting RVO as a potential marker for vascular-related cognitive decline, warranting further investigation.</p>