Evidence suggests that fine motor skills (FMS) relate to academic and cognitive development; however, findings are unclear, strewn across multiple disciplines, and lack adequate synthesis. We conducted the first comprehensive meta-analysis examining the links between different FMS facets (i.e., dexterity, speed, graphomotor, bimanual, general) and a broad range of academic-cognitive skills (i.e., sub-categories of reading, writing, mathematics, and cognition). A literature search identified 21,225 articles resulting in 118 eligible correlational studies (j = 143, k = 1110, N = 79,856). FMS exhibited significant and moderate relations with academic-cognitive skills (r = .329, d = .697). Graphomotor skills and writing showed the largest effect sizes. Mediation analysis suggested that cognitive skills mediated the link between FMS and academic skills. Overall, findings suggest that FMS share cognitive processes with academic skills, but that FMS are still related functionally to academic skills, especially writing. The discussion focuses on educational implications, moving beyond establishing if links exist to investigating why.