Introduction:
This study aimed to delineate the risk factors associated with cerebral hyperperfusion syndrome (CHS) following carotid revascularization.

Material and methods:
Comprehensive searches of the relevant medical database yielded potentially eligible studies . We conducted a meta-analysis using RevMan 5.3.

Results:
Results demonstrated that diabetes (OR = 3.16, 95% CI (1.26, 7.93), P = 0.01), coronary artery disease (OR = 1.69, 95% CI (1.04, 2.74), P = 0.03), a history of stroke (OR = 2.51, 95% CI (1.75, 3.59), P < 0.00001), degree of stenosis (OR = 1.08, 95% CI (1.02, 1.14), P = 0.008), and an operation time window of less than two weeks (OR = 3.78, 95% CI (1.83, 7.82), P = 0.0003) constituted risk factors for CHS following carotid revascularization. Conversely, robust collateral circulation served as a protective factor (OR = 0.20, 95% CI (0.10, 0.42), P < 0.0001). Other factors such as male gender (OR = 1.02, 95% CI (0.63, 1.65), P = 0.93), hypertension (OR = 1.23, 95% CI (0.77, 1.96), P = 0.39), hyperlipidemia (OR = 1.18, 95% CI (0.70, 2.00), P = 0.54), prior alcohol consumption (OR = 0.99, 95% CI (0.62, 1.60), P = 0.98), smoking history (OR = 0.82, 95% CI (0.41, 1.64), P = 0.58), intraoperative hypertension (OR = 1.73, 95% CI (0.77, 3.88), P = 0.18), and postoperative hypertension (OR = 2.81, 95% CI (0.32, 24.33), P = 0.35) showed no significant association with CHS post-revascularization.

Conclusions:
This investigation elucidated the risk and protective factors for CHS after carotid artery revascularization.