<p>Existing research on the relation between patterning skills and children’s mathematical achievement has produced inconsistent findings. To address this, the present meta-analysis synthesized 81 effect sizes from 17 studies. Results revealed a significant positive correlation between patterning skills and mathematical achievement (Fisher’s <i>z</i> = .486, <i>r</i> = .451), which indicated that stronger patterning skills were associated with better mathematical performance. Moderator analyses revealed that types of element significantly moderated the relation: patterning tasks using symbolic elements (e.g., shapes, colored blocks) had a stronger association with mathematical achievement than those using mixed elements (e.g., combining numbers and shapes), while non-pictorial elements (e.g., numbers, letters) were excluded due to insufficient sample size. Study design (intervention vs. non-intervention) also significantly moderated this relation: non-intervention studies demonstrated a stronger association between patterning skills and mathematical achievement, while intervention studies yielded weaker correlations, possibly due to variability in instructional quality. Age, patterning type (repeating, growing, mixed), and mathematical measure (researcher-based vs. standardized tests) did not significantly moderate the link. High heterogeneity across studies (<i>I</i>^<i>2</i> = 78.25%) and limitations in the sample (including a narrow age range and imbalanced subgroup sizes)&#xa0;restrict the generalizability&#xa0;of the findings. Future research should expand samples to broader developmental stages, employ causal designs to clarify the association, and further explore the underlying factors that may explain the observed heterogeneity.</p>