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This systematic review and meta-analysis was aimed at determining whether paternal age is a risk factor for offspring birth defects. A total of 38 and 11 studies were included in the systematic review and meta-analysis, respectively. Compared with reference, fathers aged 25 to 29, young fathers ( 20 years) could increase the risk of urogenital abnormalities (OR 1.50, 95 % CI 1.03-2.19) and chromosome disorders (OR 1.38, 95 % CI 1.12-1.52) in their offsprings; old fathers (≥ 40 years) could increase the risk of cardiovascular abnormali