Background Risk stratification for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) remains challenging. Programmed electrical stimulation (PES) is not endorsed by current guidelines, and its role in risk stratification is debated. We conducted a systematic review and meta-analysis to assess the association between PES inducibility and major arrhythmic events (MAE) in patients with HCM and evaluate its predictive value. Methods We searched PubMed/MEDLINE, Embase and the Cochrane Library up to 1 February 2024, for studies assessing MAE (SCD, resuscitated cardiac arrest or appropriate implantable cardioverter-defibrillator interventions) according to PES inducibility. A random-effects meta-analysis was performed to calculate pooled ORs and CIs. Sensitivity, specificity and predictive values were also calculated from the published information. Results Five studies (587 patients, 66% male, mean age 38±14 years) were included. PES inducibility was observed in 188 (32%) patien