Objective Using meta-analysis to compare the effects of inhalational anesthesia and intravenous anesthesia on the incidence of postoperative delirium. Methods The Cochrane Library, Embase, OVID MEDLINE, and Web of Science databases were searched for articles published from their establishment until March 2024. Randomized controlled trial comparing the effects of inhalational anesthesia and intravenous anesthesia on postoperative delirium incidence was included. Two researchers conducted literature screening and quality evaluation. ReviewManager 5.4 and R studio were used for meta-analysis and publication bias analysis. Results A total of 16 articles and 9470 patients were included, including 4729 cases in the inhalational anesthesia group and 4741 cases in the intravenous anesthesia group. There is no significant difference in the general risk of postoperative delirium between intravenous anesthesia and inhalational anesthesia (RR 0.99，95%CI 0.85~1.16，P=0.91)，the number and total number of delirium cases in the inhalation anesthesia group were 363/4729, while the number and total number of delirium cases in the intravenous anesthesia group were 376/4714. Specifically, there is no statistical difference in the risk of postoperative delirium in 1 day (RR 1.26, 95%CI 0.75~2.09, P=0.38,133/3344 vs. 104/3303), 3 days (RR 0.83，95%CI 0.61~1.13，P=0.23, 57/319 vs. 79/353) or 7 days (RR 1.01，95%CI 0.75~1.36，P=0.94, 193/1262 vs. 190/1282) after surgery. Conclusions There is no difference of the incidence of postoperative delirium between patients receiving inhalational anesthesia and intravenous anesthesia during the surgeries.