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Background: Carbon dioxide (CO2) laser therapy is an emerging treatment for women with stress urinary incontinence (SUI). Objectives: To examine the efficacy of CO2 laser therapy for management of SUI-related symptoms in women. Design: A systematic review and meta-analysis of randomized controlled trials and cohort studies. Data sources and methods: Four databases were screened until January 2023. All efficacy continuous endpoints were assessed via subtraction of the posttreatment from pretreatment values. The data were summarized as mean difference (MD) with 95% confidence interval (CI) using the random-effects model. Results: A total of 15 studies with 700 patients were analyzed. CO2 laser therapy significantly decreased the 1-h pad weights at 3months [n=5 studies, MD=-3.656g, 95% CI (-5.198, -2.113), p<0.001], 6months [n=6 studies, MD=-6.583g, 95% CI (-11.158, -2.008), p=0.005], and 12months [n=6 studies, MD=-3.726g, 95% CI (-6.347, -1.106), p=0.005]. Moreover, CO2 laser therapy significantly decreased the International Consultation of Incontinence Questionnaire-Urinary Incontinence Short Form Scores at 3months [n=10 studies, MD=-4.805, 95% CI (-5.985, -3.626), p<0.001] and 12-months [n=6 studies, MD=-3.726, 95% CI (-6.347, -1.106), p=0.005]. Additionally, CO2 laser therapy significantly decreased the Pelvic Floor Impact Questionnaire scores at 6months [n=2 studies, MD=-11.268, 95% CI (-18.671, -3.865), p=0.002] and 12months [n=2 studies, MD=-10.624, 95% CI (-18.145, -3.103), p=0.006]. Besides, CO2 laser therapy significantly decreased the Urogenital Distress Inventory-6 scores at 3months [n=2 studies, MD=-21.997, 95% CI (-32.294, -11.699), p<0.001], but not at 6months [n=3 studies, MD=-3.034, 95% CI (-7.357, 1.259), p=0.169]. Lastly, CO2 laser therapy significantly increased the Vaginal Health Index Score at 6months [n=2 studies, MD=2.826, 95% CI (0.013, 5.638), p=0.047] and 12months [MD=1.553, 95% CI (0.173, 2.934), p=0.027]. Conclusion: CO2 laser therapy improved the SUI-related symptoms in women. To obtain solid conclusions, future studies should be well-designed with standardized settings, consistent therapeutic protocols, and long-term follow-up periods. [ABSTRACT FROM AUTHOR]