The purpose of this study was to identify risk factors for falls in postmenopausal women and provide evidence for the primary prevention of falls in postmenopausal women. The protocol for this meta-analysis is registered with PROSPERO (CRD42020170927). We searched PubMed, the Cochrane Library and EMBASE for observational studies on the risk factors for falls in postmenopausal women. Review Manager 5.3 was used to calculate the relative risk (RR) or weighted mean difference (WMD) of potential risk factors related to falls. STATA 14.0 was used for the quantitative evaluation of publication bias. Eleven studies with 42,429 patients from 7 countries were included. The main risk factors for falls in postmenopausal women were patient sociodemographic risk factors (age:​ WMD = 0.37, 95% CI 0.07 to 0.68;​ body weight:​ WMD = 0.88, 95% CI 0.56 to 1.12;​ BMI:​ WMD = 0.34, 95% CI 0.21 to 0.46;​ exercise:​ RR = 0.97, 95% CI 0.94 to 0.99;​ and FES-I:​ WMD = 6.60, 95% CI 0.72 to 12.47) and medical risk factors (dietary calcium intake:​ WMD = − 16.91, 95% CI − 25.80 to − 8.01;​ previous fracture history:​ RR = 1.21, 95% CI 1.13 to 1.29;​ previous falls:​ RR = 2.02, 95% CI 1.91 to 2.14;​ number of diseases, < 2:​ RR = 1.17, 95% CI 1.11 to 1.23;​ and number of reported chronic health disorders:​ WMD = 0.30, 95% CI 0.10 to 0.49). Knowledge of the many risk factors associated with falls in postmenopausal women can aid in fall prevention. However, we cannot rule out some additional potential risk factors (age at the onset of menopause, years since last menstruation, hormone therapy and BMD) that need further clinical research.