Background Children and adolescents with vision impairment (VI) may be at increased risk of oral health issues, such as periodontal inflammation, poor oral hygiene, dental caries, and dental trauma, but this is inconclusive in the literature. Aim To systematically review the literature to determine the main oral health issues of children and adolescents with VI compared to those without VI. Design Electronic and manual searches were performed to identify observational studies involving children and adolescents with and without VI, to determine and compare their oral health issues. The methodological quality was assessed using the Joanna Briggs Institute critical appraisal tool. Studies that had homogeneity of methods were incorporated into meta‐analyses. Results Fifteen cross‐sectional studies were included. Overall, most studies presented methodological flaws and high risk of bias. The meta‐analysis showed that children and adolescents with VI were 3.86 times as likely to exhibit dental trauma (OR = 3.86, 95% CI = 2.63–5.68, I2 = 0%) and had higher/poorer values for plaque (MD = 0.80, 95% CI = 0.58–1.02, I2 = 96%), gingivitis (MD = 0.69, 95% CI = 0.02–1.37, I2 = 100%), calculus (MD = 0.04, 95% CI = 0.03–0.06, I2 = 0%), and oral hygiene indices (MD = 0.71, 95% CI = 0.24–1.18, I2 = 97%), as well as DMFS (MD = 0.90, 95% CI = 0.68–1.13, I2 = 26%). Conclusion Across a wide array of assessments, children and adolescents with vision impairment had worse oral health outcomes than those without VI.