<p>Cranio-maxillofacial injuries are a significant public health concern in the Middle East, driven by high rates of road traffic accidents and other trauma. Young adults, especially males, are frequently affected, leading to substantial morbidity. A comprehensive regional epidemiological synthesis is needed to inform healthcare planning and preventive strategies. To systematically review and meta-analyze the epidemiology of cranial and maxillofacial trauma in Middle Eastern populations. We conducted a systematic review and meta-analysis following PRISMA guidelines. A literature search (1996–March 2024) of PubMed, Scopus, Web of Science, and Google Scholar was performed for English-language studies reporting on the incidence or prevalence of cranial and/or maxillofacial injuries in the Middle East. Eligible studies were those documenting patient demographics, fracture sites, and aetiologies. Data from all included studies (total <i>n</i> = 10,783 patients) were extracted and pooled. Descriptive statistics and pooled prevalence rates were calculated for injury patterns and causes. Heterogeneity was assessed, and subgroup analyses were performed for fracture sub-sites in the mandible, midface, and cranial regions. Across the included studies comprising 10,783 patients, the vast majority of patients were male (80.54%; ~4.1:1 male-to-female ratio), with a mean age of 21.15 years. Mandibular fractures were the most common injury, observed in 43.6% of patients, significantly more frequent than midfacial fractures (8.2%) or cranial fractures (9.9%) (<i>p</i> &lt; 0.05). Sub-regional analysis showed that within mandibular injuries, the condylar process was the most frequently fractured sub-site (≈ 22.9% of all mandibular fractures), followed by the mandibular body (~17.5%). In the midface, zygomaticomaxillary complex fractures were most common (≈ 21.6% of midfacial fractures), followed by maxillary fractures (18.2%). Among cranial injuries accompanying facial trauma, the frontal bone was most often involved (12.7% of cranial fractures), followed by the parietal bone (~11.8%). Road traffic accidents (RTAs) were the leading cause of injury, accounting for 59.63% of all cases. Falls were the second most common cause (26.73%), and interpersonal violence (assault) accounted for 12.6%. These differences in cause distribution were statistically significant (<i>p</i> &lt; 0.05), with RTAs emerging as the predominant mechanism of injury in this region. Cranio-maxillofacial trauma in the Middle East predominantly affects young males and is largely attributable to preventable causes, chiefly RTAs. The high incidence of mandibular and cranial fractures underscores the need for improved preventive measures and safety regulations—particularly stricter traffic law enforcement and fall-prevention strategies—to reduce the burden of these injuries. These findings highlight a substantial trauma burden in the Middle East, calling for targeted public health interventions and policies to mitigate cranio-maxillofacial injuries and improve outcomes.</p>