Background: Breast cancer (BC) is the first leading cancer sharing about 25% of the cancer burden among women globally. This study aimed to identify the determinants of BC in Ethiopia.

Methods: We comprehensively searched primary studies conducted in Ethiopia on associated factors of BC in PubMed, Cochrane Library, Hinari, Google, and Google Scholar) and available online until 2 June 2023. The necessary data were extracted from relevant studies and exported to STATA version 15 for analysis. The pooled odds ratio with its 95% confidence interval (CI) was estimated using a random effect model. The finding was reported following preferred reporting items for systematic reviews and meta-analyses guidelines.

Results: Five studies with 1,819 participants (792 cases and 1,027 controls) were included. The significant determinants of BC were age at menarche <12 years (adjusted odds ratio (AOR) = 3.36, 95% CI: 1.68–5.04), post-menopause (AOR = 2.37, 95% CI: 1.67–3.06), ever breastfeeding (AOR = 0.28, 95% CI: 0.15–0.42), and family history of cancer (AOR = 2.39, 95% CI: 1.29–3.44).

Conclusion: In Ethiopia, the significant determinants of BC among women were age at menarche <12 years, post-menopause, Ever breastfeeding, and family history of cancer. We recommend that the concerned organizations consider the aforementioned factors in addressing the problem of BC in Ethiopia by increasing community awareness, promoting breast self-examination, and developing programs to reduce the increasing burden of BC in the study setting.