Objective: This study conducted a comprehensive meta-analysis to explore the etiology of meningoencephalitis in children, focusing on bacterial versus viral causes, the role of seizures, gender differences, and the association between fever and meningoencephalitis. Methods: A total of six studies comparing bacterial and viral etiologies were analyzed, encompassing 12,701 bacterial and 16,768 viral cases. Additional analyses included three studies assessing the presence of seizures, six studies evaluating gender differences, and two studies examining the association between fever and meningoencephalitis. Risk ratios (RR) and odds ratios (OR) were calculated to assess the likelihood of meningoencephalitis being associated with each factor. Results: Viral etiologies were more frequently associated with meningoencephalitis compared to bacterial causes, with a combined RR of 0.46 (95% CI: 0.19, 1.12). The presence of seizures was significantly less common in meningoencephalitis cases (OR = 0.14, 95% CI: 0.11, 0.19). Males were nearly twice as likely to develop meningoencephalitis as females (OR = 1.77, 95% CI: 0.80, 3.94). Fever emerged as a strong predictor of meningoencephalitis, with an OR of 4.87 (95% CI: 2.95, 8.02). Significant heterogeneity was observed across all analyses, reflecting variability in study populations and methodologies. Conclusion: The meta-analysis highlights the predominance of viral causes in meningoencephalitis, the reduced occurrence of seizures, the higher risk in males, and the predictive value of fever. The observed heterogeneity suggests the need for further research to better understand these associations and improve diagnostic and therapeutic approaches in pediatric meningoencephalitis.