Backgrounds: A large number of studies have investigated the effect of early menopause on osteoporosis outcomes and the relationship between the content of bone mineral density (BMD) and primary ovarian insufficiency (POI). Methods: To provide a systematic literature review and meta-analysis on BMD content among women with POI. Search strategy: We performed a systematic literature search in the databases PubMed, Embase, Cochrane Library and Web of Science databases from inception through 1 April 2022 . Selection criteria: Studies including women with POI and controls were eligible. Data collection and analysis: Two reviewers independently evaluated study eligibility. We used DerSimonian-Laird random effects model for meta-analysis. Main results: A total of 10 studies featuring 578 women with POI and 480 controls were selected. The meta-analysis showed that the BMD content of femur neck(SMD:-0.76; 95% CI: -1.20 to -0.31; P=0.0008), the BMD content of nondominating forearm (SMD:-0.67; 95% CI: -1.15 to -0.18; P=0.007) were significantly decreased in women with POI. There was no significant change in the BMD content of lumbar spine (SMD: -0.32; 95% CI: -0.74 to 0.10; P=0.14), the total hip (SMD: -0.08; 95% CI: -0.79 to 0.63; P=0.82), as well as the hip neck (SMD: -0.15; 95% CI: -0.85 to 0.56; P=0.68). Conclusions: Scientific evidence suggests that the BMD content altered in patients with primary ovarian insufficiency compared with healthy controls. Therefore, we recommend that early medical intervention (e.g., hormone replacement therapy) to minimize the risk of fracture morbidity and mortality associated with osteopenia in patients with POI.