Background: The benefits of oral caffeine intake to enhance several aspects of physical performance, such as aerobic endurance, strength, power, and muscle endurance performance, are well supported. However, how the physical performance benefits of caffeine supplementation are translated into better specific actions in intermittent sports during real or simulated competition has been the topic of fewer investigations, and their results need to be appropriately reviewed and meta-analyzed. Objective: The aim of the study was to investigate the effects of acute caffeine intake on specific actions in intermittent sports involving decision making and high-intensity efforts (eg, team, racket, and combat sports) during real or simulated competitions. Methods: All studies included had blinded and crossover experimental designs, and we conducted a risk-of-bias analysis. In total, we included 24 studies. A meta-analysis was performed using the random-effects model to calculate the standardized mean difference (SMD) estimated by Hedges g and 95% CIs. Results: Caffeine ingestion increased high-intensity sport-specific actions during competition, such as the number of sprints (SMD: 0.48; 95% CI, 0.23–0.74), body impacts (SMD: 0.28; 95% CI, 0.08–0.49), accelerations (SMD: 0.35; 95% CI, 0.06–0.63), decelerations (SMD: 0.63; 95% CI, 0.12–1.14), and high-intensity offensive efforts (SMD: 0.36; 95% CI, 0.11–0.61). Additionally, caffeine ingestion induced a higher positive or success rate of actions during real or simulated competition (SMD: 0.44; 95% CI, 0.19–0.69). Conclusion: The current meta-analysis provides evidence of caffeine supplementation in increasing high-intensity efforts and the success rate of sport-specific actions during real or simulated competition.