Background: Postpartum depression (PPD) is a major public health issue affecting maternal well-being and infant development. This systematic review and meta-analysis aimed to determine the prevalence and risk factors of PPD among Saudi women. Methods: A systematic search of PubMed, Web of Science, ProQuest, and EBSCOHost was conducted for studies published up to 31 March 2025. Statistical analysis was performed using R software (v4.4.2) with a random effects model. Study quality was assessed using the Joanna Briggs Institute (JBI) tool. Results: A total of 32 studies published between 2014 and 2024, including 10,975 women with a mean age of 30.38 ± 6.22 years, were analyzed. Prevalence of PPD varied based on the cutoff scores of the Edinburgh Postnatal Depression Scale (EPDS): 18% (95% CI: 10–27%) at EPDS ≥ 14, 30% (95% CI: 21–38%) at EPDS ≥ 13, 59% (95% CI: 33–85%) at EPDS ≥ 12, and 45% (95% CI: 28–62%) at EPDS ≥ 10. Across studies, 32 significant risk factors for PPD were identified. The most frequently reported included lack of social support, delivery method, young maternal age, and personal or family history of depression. In the meta-analysis, three factors showed statistically significant associations with postpartum depression: limited family support (p < 0.00001), poor spouse support (p < 0.00001), and unplanned pregnancy (p = 0.04). Conclusions: PPD is highly prevalent among Saudi women, with marked regional disparities. These findings highlight the need for tailored mental health strategies and region-specific interventions.