This meta-analysis evaluates the association between atrazine (ATR) exposure and small for gestational age (SGA), preterm birth (PTB), and low birth weight (LBW). A comprehensive search was done on academic databases (e.g. PubMed, Scopus, Embase, and Google Scholar) to achieve all pertinent studies up to May 2023. A pooled odd ratio (OR) and corresponding 95% confidence interval (CI) were applied to evaluate this correlation. As a result, five eligible studies met the inclusion criteria and were included in our study, and the result of the present meta-analysis showed that ATR exposure increased the risk of SGA (OR = 1.11; 95% CI = 1.03-1.20 for highest versus lowest category of ATR), PTB (OR = 1.16; 95% CI = 1.03-1.30), and LBW (OR = 1.26; 95% CI = 1.10-1.44). This meta-analysis suggests that ATR in drinking water may be a risk factor for SGA, PTB, and LBW.