Objective <p>Metacognitive training for psychosis (MCT) targets cognitive biases implicated in the pathogenesis of psychosis, e.g., jumping to conclusions, overconfidence in errors, and inflexibility. This systematic meta-review investigated the current meta-analytic evidence for the effectiveness of MCT with respect to core symptom features in schizophrenia (i.e., positive symptoms, delusions and hallucinations, negative symptoms, and overall psychotic symptoms).</p> Data sources <p>This meta-review was registered with PROSPERO (CRD42023447442) on July 28, 2023. Articles were searched across five electronic databases from January 1, 2007 to September 1, 2023.</p> Study selection <p>Meta-analyses addressing metacognitive interventions targeting psychotic symptoms were eligible for meta-review.</p> Data extraction and synthesis <p>PRISMA guidelines were followed when applicable. Data extraction was done independently by two authors (AM, AS). A random-effects model was used to pool data within meta-analyses.</p> Main outcomes and measures <p>Main outcomes were levels/severity of positive symptoms, delusions and hallucinations, negative symptoms, and overall psychotic symptoms after intervention.</p> Results <p>Eight meta-analyses and two re-analyses were included for meta-review. A total of eight analyses provided sufficient data for analysis. Significant evidence was found in favor of MCT for positive symptoms (85.71%; <i>N</i> = 35, <i>g</i> = 0.473 [0.295, 0.651], <i>I</i>^<i>2</i> = 74.64), delusions (60%; <i>N</i> = 24, <i>g</i> = 0.639 [0.389, 0.889], <i>I</i>^<i>2</i> = 80.01), hallucinations (100%; <i>N</i> = 9, <i>g</i> = 0.265 [0.098, 0.432], <i>I</i>^<i>2</i> = 6.1), negative symptoms (100%; <i>N</i> = 17, <i>g</i> = 0.233 [0.1, 0.366], <i>I</i>^<i>2</i> = 34.78), and overall symptoms (50%; <i>N</i> = 37, <i>g</i> = 0.392 [0.245, 0.538], <i>I</i>^<i>2</i> = 65.73). None of the meta-analyses included a large enough sample size to meet the criteria for ‘suggestive’, ‘convincing’, or ‘highly convincing’ evidence according to <i>metaumbrella.org</i> guidelines (required sample size &gt; 1000 cases). None of the meta-analyses scored ‘moderate’ or ‘high’ on methodological quality. Meta-analyses with significant results were more recent and/or considered more primary studies.</p> Conclusions and relevance <p>There is consistent evidence that MCT ameliorates positive symptoms and delusions in schizophrenia.</p>