Objective To explore the effect of intermittent theta burst stimulation（ iTBS） on cognitive function in older adults through meta-analysis. Methods Randomized controlled trials were collected in PubMed， Embase， Cochrane Library， China National Knowledge Infrastructure， WanFang Data， VIP and Chinese Clinical Trial Registry website， the search period was from database establishment to July 19， 2024. Meta-analysis was performed using Review Manager 5.4. Results A total of 12 papers were included， totaling 458 elderly subjects， including 231 in experimental group and 227 in control group. Meta-analysis showed that iTBS improved overall cognitive function［ standardized mean difference（ SMD）=0.68， 95%CI（ 0.35，1.01），P＜ 0.001］， memory［ SMD=0.68， 95%CI （0.26，1.10），P=0.001］， visuospatial function［ SMD=0.56， 95%CI（ 0.22，0.90），P=0.001］， language function ［SMD=0.41， 95%CI（ 0.11， 0.70），P=0.008］， and attention function［ SMD=0.81， 95%CI（ 0.41，1.22）， P＜0.001］ in older adults， and the differences were statistically significant. Analysis for various populations showed that iTBS improved cognitive function in patients with Alzheimer's disease［ SMD=0.69，95%CI（ 0.32，1.06）， P＜0.001］， and cerebrovascular disease［ SMD=1.19， 95%CI（ 0.78，1.59），P＜0.001） with statistical differences. Conclusions iTBS can improve overall cognitive function， memory， visuospatial function， language function， and attention function in older adults. Meanwhile， iTBS can improve cognitive function in patients with Alzheimer's disease and cerebrovascular disease， with limited improvement in healthy and depressive disorder populations