Medication adherence of schizophrenic patients is a growing public health problem. We conducted a meta-analysis on the influencing factors of medication compliance in schizophrenic patients. We searched PubMed, Embase, Cochrane Library, and Web Of Science for relevant articles published up to December 22, 2022. Combined odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess influencing factors. Egger’s test, funnel plot, the trim and fill method, and meta-regression analysis were used to assess publication bias. A total of 20 articles were included in the analysis. Twenty influencing factors were divided into seven categories: drug factors (OR = 1.96, 95% CI: 1.48–2.59), problem behavior (OR = 1.77, 95% CI: 1.43–2.19), income and quality of life (OR = 1.23, 95% CI: 1.08–1.39), personal characteristics (OR = 1.21, 95% CI: 1.14–1.30), disease factors (OR = 1.14, 95% CI: 1.98–1.21), support level (OR = 0.54, 95% CI: 0.42–0.70), and positive attitude and behavior (OR = 0.52, 95% CI: 0.45–0.62). This meta-analysis found that drug factors, disease factors, problem behavior, low income and quality of life, and factors related to personal characteristics appear to be risk factors for medication adherence in people with schizophrenia. And support level, positive attitude and behavior appear to be protective factors.