Drink driving is a dangerous behaviour that has severe implications for road safety. Despite decades of deterrence initiatives, drink driving remains relatively prevalent, suggesting there may be limitations within current theories used to explain the process of deterrence. In response, this study aimed to perform a systematic review and meta-analysis on what factors are associated with drink driving intentions (DDI). Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, a literature search was performed on six databases. Studies which met the inclusion criteria were correlational by design, contained a variable relating to DDI, and used generalised samples. After an initial screening process, 19 publications met the criteria for the review and 12 for the analyses. The findings showed that the theory of planned behaviour (i.e., attitudes, subjective norms, and behavioural control) sufficiently explained DDI, however, deterrence theory (i.e., risk perceptions), which was notably under-researched, revealed more ambiguous relations to DDI. Experiences with offending and avoidance were also shown to be judicious predictors of DDI, although personal punishment appeared to have a negligible impact, potentially due to the attitude of the offender toward sanctions or the low likelihood of occurrence. The review also highlighted several limitations in the current literature. Firstly, further investigation surrounding the dynamics that underlie risk perceptions of drink-driving is required to reduce the current theoretical ambiguity. Secondly, standardised approaches are needed so that research in this area is more valid and comparable. Finally, researchers may consider operating under an integrated and more comprehensive framework, as there is considerable theoretical overlap between current prominent models of offending, and such approaches will better contextualise individual variables.