Accidental perioperative hypothermia is a common but preventable surgical complication. This study aimed to review the risk factors for hypothermia in major abdominal surgery patients. Databases (CINAIL via EBSCO, Embase, Ovid MEDLINE, and Cochrane Center Register of Controlled Trials) were searched from inception to September 27, 2022. Meta-analyses were performed to calculate the pooled effects of risk factors. The Newcastle-Ottawa Scale was used to assess the quality of studies, and heterogeneity was examined by I-square tests. A total of 12 studies were involved in this review. The meta-analysis showed that hypothermia had an association with ASA (OR 0.48, 95% CI 0.30–0.77), mode of warming (OR 10.48, 95% CI 2.23–49.28), mode of presentation (OR 45.50, 95% CI 11.55–179.35), and baseline temperature (OR 5.54, 95% CI 2.30–13.25). Healthcare professionals should pay more attention to patients with these risk factors mentioned and reduce the risk of hypothermia. Besides, more evidence supported by high-quality studies is needed to explore the powers of the risk factors of hypothermia. [ABSTRACT FROM AUTHOR]