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Objective. To investigate association of incidence between pancreatic adipose infiltration and metabolic syndrome (METS). Methods. We searched PubMed, Embase, Cochrane Library, and Web of Science databases up to July 2021. We compared incidence rate of METS between adults with and without pancreatic adipose infiltration, along with their clinical features, such as fasting blood glucose (FBG), triglyceride (TG), high-density lipoprotein (HDL), and hypertension (HTN). Cross-sectional study, cohort study, and case control study were included. Two investigators independently completed study selection, data extraction, and risk of bias assessment. Results. Eleven eligible studies that involved 17,127 patients were included, including 8 cross-sectional studies, 2 cohort studies, and 1 case control study. There was a trend of increasing in incidence rate of METS (OR = 2.66 , 95% CI: 1.89-3.75) of adults with pancreatic adipose infiltration when compared to those without the disease. There was a trend of increasing in HTN (OR = 1.68 , 95% CI: 1.32-2.13) and levels of FBG (SMD = 0.54 , 95% CI: 0.35-0.72) and TG (SMD = 0.39 , 95% CI: 0.25-0.53) of adults with pancreatic adipose infiltration, while there was a trend of decreasing in HDL level (SMD = − 0.29 , 95% CI: -0.43~ -0.15). Conclusion. There was an association of incidence between pancreatic adipose infiltration and METS. Indicators of clinical features related to pancreatic adipose infiltration were more likely to arise, such as FBG and TG levels and HTN, but HDL level tended to decrease. [ABSTRACT FROM AUTHOR]