Abstract Objective To analyse and discuss the association of gender differences with the risk and incidence of poststroke aphasia (PSA) and its types, and to provide evidence-based guidance for the prevention and treatment of poststroke aphasia in clinical practice. Data sources Embase, PubMed, Cochrane Library and Web of Science were searched from January 1, 2002, to December 1, 2023. Study selection Including the total number of strokes, aphasia, the number of different sexes or the number of PSA corresponding to different sex. Data extraction Studies with missing data, aphasia caused by nonstroke and noncompliance with the requirements of literature types were excluded. Data synthesis 36 papers were included, from 19 countries. The analysis of 168,259 patients with stroke and 31,058 patients with PSA showed that the risk of PSA was 1.23 times higher in female than in male (OR = 1.23, 95% CI = 1.19–1.29, P