Abstract: Objective To systematically evaluate the accuracy of serum amyloid-like protein A (SAA) in the diagnosis of neonatal sepsis (NS).Methods A comprehensive search of Pubmed,Embase,Cochrane Library,Wanfang,China Knowledge Network and other related literature databases was conducted. The search time was from July 18,2019,and the search language was not limited.The literature was selected according to the inclusion criteria,and the quality of the included literature was evaluated using the QUADAS-2 tool. The meta-analysis was performed using Review Manager 5. 2,Metadisc 1. 4 and Stata 15. 0 software.Results A total of 14 articles and 1146 newborns were included in the study. The sensitivity of SAA diagnosis of NS was 0. 87 (95% CI: 76%-94%),and the combined specificity was 0. 88 (95% CI: 80%-93%). The DOR value was 51. 30 (95% CI: 16. 90-155. 72),and the SROC curve AUC was 0. 94 (95% CI: 0. 91-0. 96).Conclusion SAA has a high sensitivity and specificity for the diagnosis of NS and can be used for the diagnosis of NS.