Background: The ergogenic effects of caffeine in team sports, particularly basketball, have been widely investigated. This systematic review and meta-analysis evaluated the effects of caffeine intake on basketball-specific skills and general physical and game-related performance outcomes. Methods: Eighteen studies employing a blinded, crossover design were included. Random-effects meta-analyses examined the effects of caffeine intake on isolated skills (e.g., free-throw and three-point shooting accuracy, dribbling speed), general physical performance (e.g., sprint speed, jump height, and agility), and game-related actions during real or simulated matches (e.g., assists, total points scored, and performance index rating). Results: Low to moderate doses of caffeine intake improved general physical performance, including linear sprint speed (SMD: -0.27; 95% CI: -0.42- -0.13; p < 0.01), repeated-sprint speed (SMD: -0.45; 95% CI: -0.78 -0.13; p < 0.01), single-jump height (SMD: 0.15; 95% CI: 0.01-0.29; p = 0.04), and agility, reflected by shorter test completion times (SMD: -0.25; 95% CI: -0.51-0.00; p = 0.05). Low caffeine doses (2.3-3 mg/kg) did not significantly improve basketball-specific skills (i.e., shooting accuracy and dribbling speed), but were associated with enhanced overall performance during real or simulated competition (SMD: 0.25; 95% CI: 0.10-0.40; p < 0.01), alongside increased perceived muscle endurance (SMD: 0.53; 95% CI: 0.12-0.95; p = 0.01) and power (SMD: 1.01; 95% CI: 0.63-1.39; p < 0.01). Conclusion: In basketball, low-dose caffeine primarily enhances general physical rather than isolated technical skills. These findings highlight the importance of dose selection, suggesting that moderate caffeine dosage (>3 mg/kg) may be required to meaningfully influence performance in match-like basketball settings. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251060676, Identifier: CRD420251060676.
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