Abstract: OBJECTIVE To systematically evaluate the distribution of major pathogens, incidence rates and related risk factors for foodborne diseases so as to provide evidence-based bases for prevention and control of foodborne diseases. METHODS The Chinese databases including China National Knowledge Infrastructure (CNKI) and Wanfang and the English databases such as PubMed, Embase, Cochrane Library were retrieved at the same time to collect the literatures regarding the outbreak surveillance, retrospective analysis and cross-sectional survey of foodborne diseases that were published from Jan. 2010 to Dec. 2024. The screening of literatures, data extraction and quality evaluation were completed independently by 2 researchers, and meta-analysis was performed by R 4.5. 1 software. RESULTS A total of 186 studies involving 45 countries across 6 continents were included with a total sample size of 523,891 cases. Among the viruses, the prevalence rate of norovirus (pooled incidence rate: 198.30 per 100,000 person-years, 95%CI: 176.50 to 220.10) was highest, accounting for 63.20% among the foodborne viral infections. Among the bacteria, Salmonella ranked the first place (pooled incidence rate: 72.50 per 100,000 person-years, 95%CI: 65.80 to 79.20), accounting for 41.50% among the foodborne bacterial infections. Among the parasites, Toxoplasma gondii was dominant (pooled infection rate 6.80%, 95%CI: 5.30 to 8.30). Among the fungaltoxins, the exposure rate to aflatoxin was highest (contamination rate of grains 28.70%, 95%CI:24.30 to 33.10). The subgroup analysis showed that the incidence of foodborne diseases was remarkably higher in the developing countries than in the developed countries (RR=2.31,95%CI:1.98 to 2.69), the infants with no more than 5 years of age and the immunocompromised people were the high-risk populations (all P＜0.05). The heterogeneity testing indicated that I² was 78.30%, and the primary sources of heterogeneity were regional differences, diagnostic methods and age structure of populations (all P＜0.10). The sensitivity analysis confirmed that the result was robust, and Egger test revealed that there was no obvious publication bias(P=0.568). CONCLUSIONS Norovirus, Salmonella, Toxoplasma gondii and aflatoxin are the predominant pathogenic factors for the foodborne diseases. It is necessary to focus on the developing countries and special populations and strengthen the control of sources of food contamination as well as the protection of high-risk populations.