Background: Smartphone addiction is an emerging public health issue worldwide, affecting individuals across age groups, including undergraduate medical (MBBS) students. Aim: This systematic review and meta-analysis aimed to estimate the pooled prevalence of smartphone addiction among MBBS students in India and to explore variations based on the demographic, regional, and methodological factors. Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, EBSCO, and Embase for studies published up to October 01, 2024, following a PROSPERO-registered protocol (CRD42024607941). Studies reporting the prevalence of smartphone addiction among MBBS students in India were included. Two reviewers independently screened studies, extracted data, and assessed quality using the joanna brings institute (JBI) critical appraisal checklist. Meta-analysis was performed using R version 4.4.2 (2024-10-31 ucrt). Single arcsine transformation with maximum likelihood estimator was used for pooled prevalence calculation. Subgroup analyses examined differences based on the geographic region, sampling method, academic year, and type of scale used. Meta-regression assessed the influence of potential moderators. Leave one out sensitivity analysis was conducted. Publication bias was evaluated using Doi plot and luis furuya- kanamori (LFK) index. Results: Twenty-four studies were included in the analysis. The pooled prevalence of smartphone addiction among MBBS students was 60 (95 CI 45 to 73; number of studies = 24), with high heterogeneity (I² = 99.4, P < 0.001). The overall prevalence of smartphone addiction among undergraduate medical students (evaluated using screening instruments for smartphone addiction) in India is 60. Although some subgroup differences (regarding region studied, sampling method used and batch of MBBS studied) were found to be statistically significant, it is important to interpret these findings with caution, as these differences may still be influenced by chance occurrences, random error, or underlying study-level biases. Conclusion: The high prevalence of smartphone addiction among Indian MBBS students underscores the need for targeted awareness, preventive strategies, and support systems within medical institutions. Addressing this issue is critical to safeguard studentsâ�� mental health and academic performance. © 2025 Elsevier B.V., All rights reserved.