<p>Laryngotracheal stenosis (LTS) is a life-threatening narrowing of the central airway that impairs phonation and respiration, leading to significant morbidity and mortality. Early diagnosis is essential for effective management; however, delays are common, especially in low-to-middle-income countries (LMICs). Therefore, this systematic review and meta-analysis aims to definitively evaluate and compare the diagnostic test accuracy (DTA) of conventional diagnostic modalities for adolescent and adult LTS (AALTS), in order to identify the most effective and accessible strategies for timely diagnosis across diverse healthcare settings. Following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, we will include studies published from 1 January 2000 to 31 December 2024 that assess diagnostic tests for AALTS. Subgroup analyses will explore symptomatic versus asymptomatic individuals and consider demographic factors, comorbidities, and LTS classification systems. Two independent reviewers will search multiple databases-PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Scopus, Google Scholar, and Global Index Medicus-alongside grey literature via manual searches. Data analysis will use hierarchical models implemented in SAS (v9.4), R (v4.3.1), or Latent GOLD^® (v6.0) to standardise diagnostic thresholds and report sensitivity and specificity by LTS severity. We will investigate heterogeneity sources such as study design and healthcare settings, assess study quality using QUADAS-2, and perform meta-regression to explore variability in test performance. No ethical approval is required for this secondary data analysis. Results will be shared through peer-reviewed journals, conferences, and stakeholder engagement to inform clinical guidelines and reduce global disparities in LTS diagnosis. <i>Prospero registration number</i>: CRD420251044416.</p>