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Background Oral cancer is highly prevalent, which is often caused by oral potentially malignant disorders, and oral leukoplakia is the most common. The malignant transformation of oral leukoplakia not only affects the physical and mental health of patients, but also imposesa heavy economic burden on the patient's families and society. Due to limited sample size, regional differences and other factors, the epidemiological characteristics of malignant transformation in Chinese patients with oral leukoplakia in China are various. Objective To perform a systematic review of the malignant transformation rate of oral leukoplakia in Chinese patients. Methods Databases of CNKI, SinoMed, CQVIP, Wanfang Data, PubMed, Web of Science, Embase and Cochrane Library were searched to identify cohort studies about malignant transformation rate of oral leukoplakia in Chinese patients included from inception to February 2022. Two researchers separately screened the cohort studies, evaluated the qualities and extracted data. Meta-analysis was conducted using Stata 15.0. Results Thirty cohort studies including 109 047 patients were finally included. Meta-analysis revealed that the malignant transformation rate of oral leukoplakia in Chinese patients was 9.0%〔95%CI (7.0%, 11.3%) 〕. The results of subgroup analysis revealed that the malignant transformation rate was 7.6% in male patients〔95%CI (5.1%, 10.6%) 〕, and was 13.2% in female patients〔95%CI (9.5%, 17.4%) 〕. The malignant transformation rate of oral leukoplakia in patients aged