Objective To systematically evaluate the risk factors for COVID -19-associated pulmonary aspergillosis (CAPA) in patients in intensive care unit (ICU). Methods Studies on risk factors for CAPA in ICU patients were retrieved from PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database. The retrieval period was from the establishment dates of all databases to March 31, 2025. Two researchers independently screened literatures and extracted data, evaluated data quality with the Newcastle Ottawa (NOS) scale and conducted Meta-analysis using RevMan 5.4 software. Results A total of 38 observational studies were included in the analysis, including 11 312 patients. Meta-analysis results showed that male, age, smoking, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, simplified acute physiology score Ⅱ (SAPS Ⅱ), liver cirrhosis, diabetes, chronic obstructive pulmonary disease (COPD), cardiovascular disease, EORTC/MSGERC host factors, solid organ transplantation, hematological malignancies, long-term use of glucocorticoids, immunodeficiency, Charlson comorbidity index, using vasoactive drugs and/or positive inotropic drugs, mechanical ventilation, invasive mechanical ventilation, mechanical ventilation duration, renal replacement therapy, interleukin-6 inhibitor therapy were all risk factors for CAPA in ICU patients. High body mass index (BMI) and obesity were protective factors for CAPA in ICU patients (both P<0.05). Conclusion There are multiple risk factors for CAPA in ICU patients. Timely identification of relevant risk factors can help to implement standardized antifungal treatment as early as possible, so as to improve patient prognosis.