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The purpose of this meta-analysis is to estimate the size of the handwriting- visual-motor integration (VMI) relationship and examine the moderating effect of handwriting dimensions on the link. With a random effect model, a medium relation (r=.26, 95%CI [.22, .30]) between handwriting and VMI was summarized in 38 studies with 55 unique samples and 141 effect sizes. Findings suggested handwriting dimensions significantly moderated the handwriting- VMI relationship, with handwriting legibility showing a moderate correlation with VMI, but neither handwriting speed nor pressure.