Aims The present study aimed to investigate whether patients with inflammatory bowel disease (IBD) undergoing joint arthroplasty have a higher incidence of adverse outcomes than those without IBD. Methods A comprehensive literature search was conducted to identify eligible studies reporting post-operative outcomes in IBD patients undergoing joint arthroplasty. The primary outcomes in-cluded postoperative complications, while the secondary outcomes included unplanned re-admission, length of stay (LOS), joint reoperation/implant revision, and cost of care. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model when heterogeneity was substantial.Results Eight retrospective studies involving 29,738 patients with IBD were included. Compared with non- IBD controls, patients with IBD were significantly more likely to have overall com-plications (OR 2.11 (95% CI 1.67 to 2.66), p < 0.001), medical complications (OR 2.15 (95% CI 1.73 to 2.68), p < 0.001), surgical complications (OR 1.43 (95% CI 1.21 to 1.70), p < 0.001), and 90 -day readmissions (OR 1.42 (95% CI 1.23 to 1.65), p < 0.001). The presence of IBD was positively associated with the development of venous thromboembolism (OR 1.60 (95% CI 1.30 to 1.97), p < 0.001) and postoperative infection (OR 1.95 (95% CI 1.51 to 2.51), p < 0.001). In addition, patients with IBD tended to experience longer LOS and higher costs of care.Conclusion The findings suggest that IBD is associated with an increased risk of postoperative complica-tions and readmission after joint arthroplasty, resulting in longer hospital stay and greater fi-nancial burden. Surgeons should inform their patients of the possibility of adverse outcomes prior to surgery and make appropriate risk adjustments to minimize potential complications.