This meta-analysis examines the relationship between entrepreneurial ecosystem (EE) elements and regional entrepreneurial activity (EA). An extensive literature search is performed to identify quantitative studies covering EE elements and EA at the regional level (257 studies) and to extract relevant data (2,241,813 observations). To synthesize the findings, we group the potential antecedent variables based on Stam's (European Planning Studies, 23(9):1759-1769, 2015) EE framework. The results show large differences in the effect sizes and relevance of EE elements. Based on the empirical results, three relevant elements underlying all EEs are identified: demand, talent, and finance. Our results remain robust after using different methods for variable grouping, applying meta-analytic regression, and controlling for country, publication specifics, and grouping errors. Propositions for building an EE theory are derived, and future research opportunities are discussed, as well as policy implications. A meta-analysis of entrepreneurial ecosystems and their effects on entrepreneurial activity shows that elements of entrepreneurial ecosystems vary substantially in their importance for different kinds of new business formation. Entrepreneurial ecosystems (EEs) have grown in importance in entrepreneurship research over the last decade, attracting significant attention from both researchers and practitioners. One reason for this high level of interest is that the concept of EE provides a fresh lens for describing how entrepreneurial activity (EA) varies between locations, an issue that scholars have long examined. It has been proposed that many elements of EEs join together to form a regional ecosystem generating EA as its output. It is unclear, however, whether all presented EE elements are relevant for EA, as well as how relevant they are in relation to each other. This study aims to investigate EA through the lens of EE and examines the EE elements that have been considered in previous empirical research. It investigates the existence and strength of links between EE elements and EA before identifying essential EE elements to further advance EE theory development. This paper adopts an evidence-based research approach and uses meta-analysis to identify antecedents of EA at the regional level. Our results show that demand, finance, and talent element measures are important antecedents for general EA, while culture, knowledge, and support services are important antecedents for productive EA. This contribution is important for empirical researchers and policymakers alike. Researchers can use the provided information to refine their empirical models, while policymakers can develop and implement instruments that stimulate the desired EA type within an ecosystem. Moreover, the study advances the theoretical modeling of EE regarding core components depending on the type of EA.