Objective To synthesize and evaluate the effectiveness of different active warming interventions for preventing intraoperative hypothermia in adults, and to provide a reference for nurses′ clinical decision-making.Methods Comprehensive searches were performed in eight Chinese and English databases (CNKI, Wanfang Data, SinoMed, PubMed, Web of Science, Cochrane Library, Embase, CINAHL) and supplemented by reference and grey literature searches for meta-analyses and systematic reviews (SRMAs) on warming measures to prevent intraoperative hypothermia.The search-covered records from database inception through June 30, 2025.Methodological quality of included reviews was assessed with the Chinese version AMSTAR 2 tool, and evidence quality for outcomes was graded using the GRADE tool.Results Thirteen SRMAs were included.Methodological appraisal rated 2 SRMAs as high quality, 1 as moderate quality, 8 as low quality, and 2 as very low quality.Across 31 evidence items, 11 were graded moderate, 13 low, and 7 very low quality.The evidence indicates that forced air warming, combined warming strategies, warmed intravenous fluids, and heated humidified breathing circuits can effectively reduce the incidence of intraoperative hypothermia, help maintain stable intraoperative core temperature, and decrease the occurrence of shivering.Conclusion Active warming interventions are beneficial for preventing intraope-rative hypothermia in adults.Combined warming strategies are recommended as a priority; routine use of forced air warming is advised, with warmed intravenous fluids as a complementary measure.The effectiveness and optimal use of heated humidified brea-thing circuits and other active warming modalities warrant further high quality research.