This systematic review and meta-analysis examines the impact of the retail food environment on obesity. The study aimed to assess the associations between food outlet availability and obesity using spatial environmental analyses. A total of 103 studies were included, with density and regression analyses being the most common methods used. The findings indicate that proximity to fast-food outlets is positively associated with obesity, while proximity to supermarkets and fresh fruit and vegetable stores is inversely associated with obesity. The study highlights the need for comprehensive strategies, including regulation of in-store food environments and zoning laws, to improve access to healthy food options and reduce obesity rates. The results provide valuable insights for policymakers and urban planners to develop effective interventions and policies aimed at fostering healthier communities.This systematic review and meta-analysis examines the impact of the retail food environment on obesity. The study aimed to assess the associations between food outlet availability and obesity using spatial environmental analyses. A total of 103 studies were included, with density and regression analyses being the most common methods used. The findings indicate that proximity to fast-food outlets is positively associated with obesity, while proximity to supermarkets and fresh fruit and vegetable stores is inversely associated with obesity. The study highlights the need for comprehensive strategies, including regulation of in-store food environments and zoning laws, to improve access to healthy food options and reduce obesity rates. The results provide valuable insights for policymakers and urban planners to develop effective interventions and policies aimed at fostering healthier communities.