<p>This study aimed to compare and evaluate the prediction accuracy and risk of bias (ROB) of post-traumatic stress disorder (PTSD) predictive models. We conducted a systematic review and random-effect meta-analysis summarizing predictive model development and validation studies using machine learning in diverse samples to predict PTSD. Model performances were pooled using the area under the curve (AUC) with a 95% confidence interval (CI). Heterogeneity in each meta-analysis was measured using I². The risk of bias in each study was appraised using the PROBAST tool. 48% of the 23 included studies had a high ROB, and the remaining had unclear. Tree-based models were the primarily used algorithms and showed promising results in predicting PTSD outcomes for various groups, as indicated by their pooled AUCs: military incidents (0.745), sexual or physical trauma (0.861), natural disasters (0.771), medical trauma (0.808), firefighters (0.96), and alcohol-related stress (0.935). However, the applicability of these findings is limited due to several factors, such as significant variability among the studies, high and unclear risks of bias, and a shortage of models that maintain accuracy when tested in new settings. Researchers should follow the reporting standards for AI/ML and adhere to the PROBAST guidelines. It is also essential to conduct external validations of these models to ensure they are practical and relevant in real-world settings.</p>