PURPOSE: Serious complications and unplanned healthcare utilization are reported among inflammatory bowel disease (IBD) hospitalizations with associated cytomegalovirus (CMV). The present systematic review and meta-analysis aimed to examine the in-hospital outcomes of CMV-related hospitalization in IBD patients. METHODS: Electronic databases were systematically searched in PubMed, Web of Science (ISI), Scopus, Embase, and Google Scholar until February 2024. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Cochran's Q test and I(2) statistics were applied to evaluate potential heterogeneity across eligible studies. The random-effects model obtained pooled odds ratio (OR) estimates and associated 95% confidence intervals (CI). RESULTS: Sixteen articles were included in the meta-analysis, encompassing 5120 IBD patients diagnosed with comorbid CMV infection. Our findings indicated that compared to IBD patients without CMV, those with both CMV and IBD had a longer hospital length of stay (LOS) (8.65 days longer; 95% CI: 6.96, 10.34; P < 0.01), a greater colectomy risk (OR = 2.26; 95% CI: 1.53, 3.34; P < 0.01), and higher in-hospital mortality (OR = 2.83; 95% CI: 1.92, 4.16; P < 0.01). However, the difference in hospital charges between the two groups was not statistically significant (P = 0.78). Sensitivity analysis using the leave-one-out approach revealed significant changes in hospital costs after excluding certain studies. Additionally, subgroup analyses showed significant differences based on IBD subtypes for surgery risk and LOS. CONCLUSION: Our findings suggest that CMV infection is associated with poorer outcomes in hospitalized IBD patients, highlighting the importance of early detection and appropriate management of CMV infection in this population to improve clinical outcomes and reduce healthcare resource utilization.