Stress is defined as a person's interaction with their environment that is thought to threaten or affect an individual's potential, resources, and well-being. The most popular instrument to assess perceived stress is the Perceived Stress Scale (PSS). Therefore, making a systematic review of studies testing the internal structure of PSS and conducting a Meta-Analytic Confirmatory Factor Analysis (MACFA) on the database created with the information obtained from these studies are the aims of this research. A total of 76 samples from 57 unique studies were included in this database using various inclusion criteria (total N for PSS-14 = 28,632, for PSS-10 = 46,053). The correlated two-factor model for PSS was confirmed by MACFA performed on the pooled correlation matrix generated by the random effects meta-analysis. Findings of dimensionality analyses, factor loadings, omega values, and measurement invariance showed that the model that best explained the factor structure of PSS was the correlated two-factor model. The strict measurement invariance of the PSS was achieved across age and clinical status, and the internal consistency was high according to the omega values. Several recommendations moving forward are discussed.