Objective To systematically review the association between exposure to bisphenol A during pregnancy and spontaneous abortion. Methods The PubMed, Web of Science, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to identify cohort studies and case-control studies related to bisphenol A exposure and spontaneous abortion from inception to April 1st, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. Results A total of 7 case-control studies and 1 cohort study were included, with a total of 1 179 subjects. The results of meta-analysis showed that there was a statistically significant difference in bisphenol A concentrations between the spontaneous abortion group and the control group regardless of whether the sample source was serum or urine (SMD serum=1.05, 95%CI 0.34 to 1.77, P=0.004; SMD urine=0.20, 95%CI 0.02 to 0.38, P=0.027). Conclusion The current evidence shows that exposure to bisphenol A during pregnancy may lead to unexplained recurrent spontaneous abortion. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.