Abstract Objective The H7N9 avian influenza virus, identified in China in 2013, has posed a significant threat to public health due to its high mortality rate . This systematic review aims to evaluate the clinical characteristics and mortality risk factors of H7N9 patients. Methods English and Chinese databases (PubMed, Web of Science, Embase, CNKI, VIP, Wanfang) were searched for studies on laboratory-confirmed H7N9 cases with available data on symptom onset, diagnosis time, clinical features, oseltamivir administration, and outcomes . Univariate and multivariate analyses were performed on the pooled case data to assess the relationship between clinical factors and mortality risk. Results A total of 166 studies including 237 H7N9 cases were analyzed , with an overall mortality rate of 41.77%. Univariate analysis showed higher mortality in patients with advanced age ≥ 66 years (62.50%), those with underlying diseases (60.20%), those who received oseltamivir ≥ 8 days after symptom...