The diagnosis of malignant mesothelioma (MM) remains a clinical challenge and the fluorescence in situhybridization (FISH) assay has been reported to be one promising tool. The present meta-analysis aimed toestablish the overall diagnostic accuracy of FISH for diagnosing MM. After a systematic review of Englishlanguage studies, the sensitivity, specificity and other measures of accuracy of FISH in the diagnosis of MMwere pooled using random-effects models. Summary receiver operating characteristic curves were applied tosummarize overall test performance. Nine studies met our inclusion criteria, the pooled sensitivity and specificityfor FISH for diagnosing MM being 0.72 (95% CI 0.67-0.76) and 1.00 (95% CI 0.98-1.00), respectively. The positivelikelihood ratio was 34.5 (95% CI 14.5-82.10), the negative likelihood ratio was 0.24 (95% CI 0.16-0.36), andthe diagnostic odds ratio was 204.9 (95% CI 76.8-546.6), the area under the curve being 0.99. Our data suggestthat the FISH assay is likely to be a useful diagnostic tool for confirming MM. However, considering the limitedstudies and patients included, further large scale studies are needed to confirm these findings.