Introduction:
Enlarged perivascular spaces (EPVS) are ubiquitous in the elderly and have insidious onset characteristics. Its correlation with clinical symptoms is easily overlooked and controversial. The related clinical symptoms that EPVS may cause were studied using Meta-analysis.

Material and methods:
Relevant studies up to April 2022 were extracted from PubMed, Embase, Cochrane, OVID, and Web of Science. Odds ratios (ORs) and 95% confidence interval (CI) were used to estimate the strength of the correlation.

Results:
Of the 6622 articles identified, 32 studies were eligible, enrolling a total of 19987 people. EPVS was associated with the risk of cognitive impairment (OR: 1.60, 95 % CI: 1.39- 1.81), motor impairment (OR: 2.24, 95 % CI: 1.22- 3.25), sleep disturbance (OR: 1.81, 95% CI: 1.34-2.28), depressive symptoms (OR: 1.54, 95 % CI: 1.14- 1.95), but was not significantly associated with the occurrence of stroke ( OR: 0.97, 95 % CI: 0.74-1.21). Results of subgroup analysis showed that basal ganglia (BG) EPVS were more associated with cognitive impairment (OR: 2.19, 95% CI: 1.72- 2.65) and sleep disturbance(OR: 1.74, 95 % CI: 1.20- 2.29).

Conclusions:
Our findings suggested that people with EPVS may be at a greater risk for cognitive impairment, motor impairment, sleep disturbance, and depressive symptoms. This will inform future treatments.