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The usage of social networking sites (SNSs) represents one of the most significant behavioral shifts in recent years. WhatsApp, Facebook, Instagram, X, and YouTube, among others, have become an inseparable part of our daily life, especially in the present hyperconnected era. However, the use of SNSs can shift from a normal daily habit to an excessive and hard-to-control behavior, negatively affecting physical and mental health and causing Problematic Social Media Use (PSMU). PSMU is a serious problem that continues to grow with the ongoing development of new SNSs and the increasing integration of artificial intelligence (AI) features, influencing the SNSs’ metrics and algorithms, personalizing content, strengthening platform engagement, and attracting an even greater number of users. In this context, exploring the effects of PSMU requires more attention, especially among a population at high risk: university students. One relevant question that arises when considering both social media use (SMU) and university life is academic performance (AP) and how PSMU affects it. The present review aims to address this question and explore the relationship between PSMU and AP, with a focus on university students in the Middle East and North Africa (MENA) region, where social media adoption is widespread and the prevalences are continuously increasing. The present review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We first developed our research equation via the Boolean research strategy. We subsequently conducted a deep search and careful filtration to select consistent studies that met our inclusion and exclusion criteria across four databases, namely, PubMed, Web of Science, Scopus, and ScienceDirect. We included only quantitative observational cross-sectional studies that (i) explored the association between PSMU and AP, (ii) included university students from the MENA region only, and (iii) evaluated PSMU relying on scales, not merely by time spent and frequency of use. Our screening process resulted in the selection of eleven studies. By analyzing and comparing their findings, most included studies reported a negative association between PSMU and AP among university students in the MENA region. An exploratory meta-analysis, conducted to examine variability in effect sizes, yielded a negative, non-statistically significant pooled association (r = -0.114, 95% CI: -0.283 to 0.054), with substantial heterogeneity observed across studies (I2 = 76.86%). These findings highlight marked variability in the reported associations and underscore the need for more standardized methodologies to support more robust future synthesis. While our review identified a negative association between PSMU and AP among university students in the MENA region based on the narrative synthesis, findings from the exploratory meta-analysis highlighted substantial variability in effect sizes, limiting the ability to derive a consistent quantitative estimate. Furthermore, causal inferences remain limited due to the cross-sectional nature of the included studies. Given the limited number of available studies, inconsistency in PSMU measurement, variability in the operationalization of AP, and lack of data on mediating mechanisms, further region-specific research is essential. Beyond cross-sectional designs, longitudinal and interventional studies with clearer reporting practices are warranted to advance understanding of this relationship.