Objective: To determine the incidence of adverse events (AEs) associated with umbilical catheters in the neonatal population. Study design: Systematic review and meta-analysis of observational studies and randomized controlled trials published between 2010 and 2020. Results: In total 14,226 umbilical venous catheters (UVCs) and 4228 umbilical arterial catheters (UACs) were included. Overall, 13.4% of UVCs were associated with an AE (95% CI: 10.1–17.0) or 2.4 per 1000 catheter days (95% CI: 1.8–3.0). UACs had an AE rate of 9% (95% CI: 5.9–12.8) or 0.87 per 1000 catheter days (95% CI: 0.4–1.3). UVC malposition was the most common (41.7% [95% CI: 27.6–56.5]). Local injury from UAC taping was the most common AE in one study. Conclusions: Umbilical catheters have a high incidence of AEs. Research into accurate methods of tip verification, tip surveillance, and securement is required.