The rapid advancement of emerging technologies has transformed managerial paradigms; however, a comprehensive understanding of strategic decision-making in startups remains theoretically underdeveloped. This study aimed to develop a comprehensive framework of the factors affecting strategic decision-making in startups in the era of artificial intelligence. This applied qualitative study employed a meta-synthesis approach based on the seven-step model proposed by Sandelowski and Barroso. The study corpus consisted of peer-reviewed articles published in national and international scientific databases between 2019 and 2026. Following a systematic screening process, 48 articles were selected for the final analysis. Data were collected using meta-synthesis data extraction forms and analyzed through coding and qualitative content analysis. The findings revealed six major categories of factors affecting startups' strategic decision-making: cognitive and process-related factors, technological factors, organizational factors, human–artificial intelligence interaction factors, environmental factors, and risks and challenges encompassing technical, human, ethical, organizational, and strategic dimensions.The findings suggest that successful strategic decision-making in startups depends on adopting hybrid decision-making models and achieving synergy between the analytical capabilities of artificial intelligence and the intuitive judgment of entrepreneurs.