Climate-smart agriculture technologies and innovations (CSATIs) are critical for food security and climate challenges, but face low adoption rates due to region-specific barriers. This systematic review and meta-analysis synthesized evidence from 99 studies (1994-2024) and uses random effects models, correspondence factor analysis, and time-series analysis to identify trends and critical barriers. General agricultural practices dominate research (41.1%), while postharvest management (4.5%) and agricultural processing (4.0%) are under-researched. Socioeconomic, informational, and institutional barriers emerged as the most significant challenges, often linked to financial constraints. Institutional barriers predominate in West Africa, while socioeconomic factors persist in Southern Africa. Financial barriers vary with economic conditions, whereas socioeconomic barriers persist. Technological and biophysical barriers also affect adoption, but receive less attention. Tailored interventions such as subsidized credit, community-driven initiatives, and improved knowledge dissemination are crucial. More research is needed on postharvest management and agricultural processing. Context-specific strategies, including institutional reforms and improved extension services, are essential for greater dissemination of CSATI. Without immediate action, regional disparities will persist, undermining agricultural resilience and food security. Holistic, inclusive approaches are imperative to improve the livelihoods of smallholder farmers and achieve climate adaptation goals.