We aimed to compare the outcomes of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) between elderly and non-elderly patients utilizing a systematic review and meta-analysis. Repositories of PubMed, Embase, Scopus, and Web of Science were searched up to 25 January 2025 for all comparative studies providing data on the adequacy of the sample obtained from the procedure, procedure duration, and complications. Random-effects meta-analysis was conducted. Six studies were eligible. Meta-analysis showed no statistically significant difference in procedure duration, inadequate sampling, and all complications between elderly and non-elderly groups. There was no statistically significant difference between elderly and non-elderly for specific complications like bleeding, cardiovascular events, and hypoxemia. Subgroup analysis based on the definition of elderly did not change the results of inadequate sampling and all complications. Descriptive analysis of the diagnostic accuracy of EBUS-TBNA for malignant lesions showed no difference between the two groups. EBUS-TBNA seems to have similar diagnostic yield and complication rates in the elderly as compared to the non-elderly population. More studies are needed to improve the quality of evidence.