Background <p>Declining fertility rates have raised concerns about potential population crises in many nations. While previous studies have established the link between female education and fertility intentions, no global meta-analysis has examined the fertility intentions of highly educated women.</p> Methods <p>We searched Medline, Embase, Global Health, and APA PsycExtra for studies published between January 2000 and December 2022, without language restrictions. Eligible studies included cross-sectional, longitudinal, case-control, intervention, and qualitative studies that reported fertility intentions or influencing factors among females with at least a post-secondary education. We excluded abstracts, conference proceedings, letters, commentaries, editorials, reviews, and preprints. The pooled proportion of fertility intentions was estimated through a random-effects meta-analysis. We analyzed factors that influence fertility intentions using a data-based convergent synthesis design.</p> Results <p>Out of the initial 4,804 studies identified, 35 studies were eligible for inclusion. The meta-analysis of fertility intentions included 17,292 highly educated women from 19 countries. The pooled proportion of highly educated women who did not expect children in the future was 12.2% (95% CI 8.4–16.7%), with substantial variation across regions, from 5.1% (2.6–8.3%) in the European Region to 22.9% (13.6–33.7%) in the Western Pacific Region. Factors associated with fertility intentions included not only the pursuit of a career and education (individual-level), the need for stable relationships and family support (family-level), but also (un)supportive environments (community-level), labor market and childcare services (institutional-level), and social norms and national policies (structural-level).</p> Conclusion <p>Regional disparities in fertility intentions among highly educated women reflect underlying differences in social welfare systems, labor market structures, and gender norms. Policies aimed at supporting fertility in this group should move beyond a narrow focus on individual preferences and instead address the broader contextual factors that shape reproductive decision-making. Creating a supportive environment for parenting, through equitable leave entitlements, accessible childcare, and family-friendly employment policies, may contribute to fostering informed fertility choices among highly educated women.</p> Trial registration <p>CRD42023404366.</p>