Objective To systematically review the status of alexithymia in Chinese elderly population.Methods CNKI, VIP, CBM, WanFang Data, PubMed, EMbase, Web of Science, PsycINFO and The Cochrane Library databases were electronically searched to collect cross-sectional studies related to the epidemiological characteristics of alexithymia among elderly people in China from inception to February 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by using Stata 16.0 software.Results A total of 11 cross-sectional studies involving 3 592 older adults were included. The results of meta-analysis showed that the prevalence of alexithymia in Chinese elderly was 36% (95%CI 30% to 42%), and the scores of alexithymia was 58.59 (95%CI 54.60 to 62.57). Subgroup analyses indicated that the prevalence of alexithymia was 39% (95%CI 32% to 45%) in northern China, 33% (95%CI 30% to 37%) in northeast China, 36% (95%CI 31% to 41%) in eastern China, 51% (95%CI44% to 58%) in central China, and 20% (95%CI 16% to 24%) in the southwest China. The prevalence rates of hospitalized, nursing home and community elderly were 42% (95%CI 34% to 49%), 37% (95%CI 28% to 45%) and 29% (95%CI 20% to 38%), respectively. The scores of alexithymia was higher among the elderly who were male, 80 years or older, engaged in heavy physical work before retirement, suffer from severer chronic diseases, low education background, low monthly income, living alone, low frequency of participate in group activities and visited by relatives.Conclusions Current evidence shows that the overall prevalence of alexithymia is high in Chinese elderly population, and varies with regions. The level of alexithymia among gender, age, occupation before retirement, number of chronic diseases, educational level, monthly income, habitation manner, the frequency of participating in group activities and being visited by relatives and friends is different.