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Objective: This study aimed to investigate the association between a history of recurrent spontaneous abortion (RSA) and adverse outcomes in women with spontaneous conception. Methods: A search strategy from the inception to March 3, 2023 was run in PubMed, Embase, Cochrane Library, and Web of Science databases. The odds ratio (OR), and the 95% confidence interval (CI) or point estimation were used as the evaluation indexes. Each outcome measure tested was assessed for heterogeneity using the Cochran Q test. Sensitivity analyses were performed to test the credibility of the meta‐analysis results. Results: Fifteen studies involving 1 475 389 pregnant women were included. A history of RSA was associated with gestational diabetes (OR: 2.21, 95% CI: 1.70–2.87, p < 0.001), preeclampsia (OR: 2.06, 95% CI: 1.49–2.86, p < 0.001), placenta previa (OR: 1.82, 95% CI: 1.09–3.02, p = 0.021), placental abruption (OR: 1.67, 95% CI: 1.36–2.06, p < 0.001), miscarriage (OR: 6.37, 95% CI: 3.83–10.57, p < 0.001), preterm birth (OR: 1.80, 95% CI: 1.36–2.37, p < 0.001), cesarean section (OR: 1.47, 95% CI: (1.13–1.91, p = 0.004), perinatal death (OR: 2.24, 95% CI: 1.39–3.60, p = 0.001), and neonatal intensive care unit admission (OR: 1.39, 95% CI: 1.01–1.92, p = 0.047). However, the associations of a history of RSA with gestational hypertension, small for gestational age, fetal anomalies, fetal growth restriction, and postpartum hemorrhage were not observed. Conclusion: This meta‐analysis indicates a history of RSA was associated with increased risks of several adverse outcomes in pregnant women with spontaneous conception. [ABSTRACT FROM AUTHOR]