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This paper systematically reviews the literature on levels of eco-emotions reported by young adults (aged 18-29) across nations, with meta-analyses of associations between eco-anxiety and mental health outcomes. Fourteen databases were searched for relevant studies. Fifty-nine studies reported levels of eco-emotions, with 37 studies reporting associations between eco-anxiety and each of anxiety, depression, and stress. Eco-anxiety was the most reported eco-emotion. Higher scores of eco-anxiety and eco-fear were reported by populations facing direct environmental impacts. Eco-anger and eco-hope were reported to have a role in adaptive coping. Meta-analyses indicated moderate, significant positive associations between eco-anxiety and depression r = 0.29, anxiety r = 0.34, and stress r = 0.30. Meta-regressions were conducted to explore heterogeneity. Our results highlight the importance of addressing heterogeneity in operationalizing the construct of eco-anxiety and the need to collect data on eco-emotions in low-and-middle-income nations, which is lacking in the current literature.