Background and Objective: Rectal washout with saline solution may theoretically prevent anastomoticrecurrence in patients with resectable rectal cancer, although exact clinical effects have not yet been determined. Inorder to derive a more precise estimation of the relationship, the present meta-analysis was performed. Method:Relevant studies were identified by a search of Medline, Embase and Google Website with no restrictions toSeptember 1, 2013, and included in the systematic review and meta-analysis. Results: 5 trials (642 participants)were included to assess the association between rectal washout with saline solution and anastomotic recurrence.The rate of anastomotic recurrence (AR) was 6.23% (40/642), with the pooled OR derived from the five studiesbeing 0.32 (95 % CI=0.15–0.70, P=0.004). The pooled OR derived from the TME and radical resection subgroupswere 0.72 (95%CI=0.16–3.12, P=0.66) and 0.51 (95%CI=0.13–1.96, P=0.32), respectively. Conclusion: Resultsfrom this analysis show that intra-operative rectal washout with mere saline solution largely reduces the risk ofanastomotic recurrences in patients with resectable rectal cancer.