Background: Cervical cancer, as one of the malignant tumors threatening women’s health and survival, has demonstrated a marked increase in incidence in China. In recent years, the HPV vaccine has become an effective preventive measure against cervical cancer, with college students representing an important target group for HPV vaccination. Therefore, comprehensive and professional conclusions are needed to guide the improvement of the cervical cancer prevention and treatment service system regarding the willingness to receive the HPV vaccine and the actual vaccination rate among college students in China. Methods: Relevant studies were retrieved from PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, PsycINFO, SinoMed, CNKI, Wanfang, and VIP Database from the time the databases were established to March 12, 2025. Meta-analysis was conducted using Stata 17.0 and RevMan 5.4 to assess college students’ willingness to receive HPV vaccination, actual vaccination status, and influencing factors. Results: A total of 35 studies involving 62,958 samples were included. The meta-analysis results showed that the willingness rate of college students to receive HPV vaccination in China was 67.0% (95%CI: 0.61-0.74, P<0.001), and the actual vaccination rate was 9.0% (95%CI: 0.07-0.11, P<0.001). Fifteen influencing factors were extracted. Female (OR=3.47, 95%CI: 2.49-4.85, P<0.001), having a history of sexual behavior (OR=1.91, 95%CI: 1.09-3.35, P=0.020), accepting premarital sex (OR=1.36, 95%CI: 1.04-1.78, P=0.020), having a family history of tumors (OR=1.69, 95%CI: 1.28-2.23, P<0.001), monthly consumption level ≥ 2000 yuan (OR=1.50, 95%CI: 1.22-1.84, P<0.001), knowing about HPV vaccine (OR=1.75, 95%CI: 1.11-2.77, P=0.020), knowing that HPV vaccine is on the market (OR=1.71, 95%CI: 1.44-2.03, P<0.001), knowing that HPV infection is related to cervical cancer (OR=1.44, 95%CI: 1.15-1.81, P=0.002), having someone around who has been vaccinated with HPV vaccine (OR=2.23, 95%CI: 1.66-3.01, P<0.001), and having a high cognitive score of HPV and its vaccine (OR=1.86, 95%CI: 1.32-2.62, P<0.001) were identified as influencing factors. Conclusion: Current evidence indicates that while the willingness rate of college students in China to receive HPV vaccination is relatively high, the actual vaccination rate is low. Public health authorities and healthcare institutions should face the problem of ”high vaccination willingness rate and low actual vaccination rate” among college students by strengthening the professional popularization of HPV vaccine-related knowledge and optimizing the HPV vaccination service system to enhance cervical cancer prevention efforts.