Although several studies have investigated the long-term association of respirable particulate matter (PM ≤10 µm) with the incidence of myocardial infarction (MI), this association is inconclusive or even contradictory. This systematic review and meta-analysis study aimed to quantify the long-term efect of exposure to respirable PM on the incidence of MI. To fnd relevant publications, online databases, including Scopus, PubMed, and Web of Science, were searched on October 10, 2021. A random-efect model was used to calculate the pooled hazard ratio (HR) and 95% confdence interval (95% CI) of MI across studies. Heterogeneity was presented with reporting I 2 index. Of 4591 records found in the primary searching, the number of 24 prospective cohort studies with more than 70 million participants was included. The pooled HR (95% CI) of MI per 1 µg/m3 increment of respirable PM was estimated as 1.01 (1.00, 1.01). Subgroup analyses according to aerodynamic diameter of PM showed an only signifcant stronger risk of MI per 1 µg/m3 increase in PM with aerodynamic diameter.