Objective: To apply eye-tracking technology to measure the fixation duration of children and adolescents with autism spectrum disorder (ASD) towards emotional faces, so as to provide potential objective indicators for the diagnosis and intervention of ASD. Methods: Case-control studies related to emotional faces in ASD children and adolescents aged 3-18 years were searched in PubMed, Web of Science, CNKI and Wanfang, with a search period spanning from the inception of the databases to April 1, 2024. The Newcastle-Ottawa Scale (NOS) was employed to assess the quality of the retrieved articles, and a Meta analysis was conducted by Stata 17.0 software. Results: A total of 18 articles were included, encompassing 361 participants in the ASD group and 413 in the control group. All studies scored ≥6 on the NOS, indicating high research quality. Compared to the control group, the ASD group demonstrated significantly shorter fixation duration ( P <0.01) towards specific emotional faces, including happy faces under the paradigm of self-made and same ethnicity emotional faces ( SMD =-1.05, -1.16), neutral faces in domestic literature ( SMD = -1.00), angry and sad faces under clinical diagnosis criteria ( SMD =-1.73, -1.29), and fearful faces under Chinese Classification and Diagnostic Criteria of Mental Disorders, Version 3 (CCMD-Ⅲ) ( SMD =-1.51). Conclusion Children and adolescents with ASD exhibit abnormal eye tracking indicators towards certain emotional faces, which may serve as early warning indicators for the diagnosis of ASD.