The efficiency of urban waste collection and transportation systems is critical for sustainable solid waste management, especially in rapidly urbanizing cities such as Port Harcourt, Nigeria. This study conducted a systematic review and meta-analysis of peer-reviewed literature and grey sources to evaluate the operational performance and challenges in waste collection and transportation in Port Harcourt. A comprehensive database search yielded 1,253 records, of which 18 studies met inclusion criteria for systematic review, and 12 were eligible for meta-analysis. Findings revealed widespread inefficiencies in waste collection frequency, route optimization, fleet management, and community participation. Only 45–60% of urban households received regular waste collection, while poor road infrastructure and outdated trucks contributed significantly to delays and operational costs. Informal waste collectors play a crucial role in bridging service gaps, yet remain unregulated. The meta-analysis showed that optimized transportation strategies and public-private partnerships (PPPs) improved system efficiency by up to 40%. The study concludes with strategic recommendations to enhance collection and transportation efficiency, including digitized route planning, decentralized waste services, and integration of the informal sector. These findings offer policy-relevant insights for strengthening urban waste systems in Nigerian cities.