Objective To systematically evaluate the incidence and risk factors of pulmonary hypertension (PH) associated with bronchopulmonary dysplasia (BPD) in preterm infants. Methods Cohort and case-control studies on the incidence and risk factors of PH complicating BPD (hereinafter referred to as BPD-PH) in preterm infants, published from database inception to July 2024, were retrieved from China National Knowledge Infrastructure, Wanfang Data, VIP Database, Chinese Biomedical Literature Database, PubMed, Web of Science, Embase, MEDLINE, and Cochrane Library. Meta analysis was performed using Stata 15.0 software. Results A total of 15 studies involving 4 561 preterm infants were included. Meta analysis results showed that the overall incidence of BPD-PH in preterm infants was 20.1% (95%CI: 16.1%-24.0%). Hemodynamically significant patent ductus arteriosus (OR=3.43), mechanical ventilation duration (OR=1.05), small for gestational age (SGA) (OR=7.30), severe BPD (OR=13.25), patent ductus arteriosus requiring surgical ligation (OR=6.03), oligohydramnios (OR=7.24), ventilator-associated pneumonia (OR=3.97), and respiratory distress syndrome (OR=2.70) were identified as risk factors for BPD-PH in preterm infants (P<0.05). Conclusions The overall incidence of BPD-PH in preterm infants is relatively high. Hemodynamically significant patent ductus arteriosus, mechanical ventilation duration, SGA, severe BPD, patent ductus arteriosus requiring surgical ligation, oligohydramnios, ventilator-associated pneumonia, and respiratory distress syndrome can increase the risk of PH in preterm infants with BPD, and clinical monitoring should prioritize BPD infants with these high-risk factors.