Studies on the association between passive smoking and head and neck cancer (HNC) are controversial. This meta-analysis aimed to explore this association. A systematic search of the PubMed, Embase, Web of Science, and Cochrane Library databases was conducted up to July 2024 to identify relevant studies. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the DerSimonian–Laird random-effects model. Heterogeneity among studies was assessed, and the risk of bias was evaluated. A total of 1036 records were identified, of which 17 studies were included. Passive smoking was significantly associated with an increased risk of HNC overall (OR = 1.70, 95% CI: 1.27–2.28, P