Performing a systematic review and meta-analysis to evaluate the diagnostic performance of the total prostate-specific antigen (tPSA) tests for diagnosis of prostate cancer among Chinese. Literatures related to diagnosis of prostate cancer by tPSA and the ratio of free to total PSA (f/tPSA) being retrieved in five electronic databases. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio (DOR) were pooled using random effects models. Summary receiver operating characteristic curves (SROC) used to summarize overall test performance. In total 10 studies meeting the inclusion criteria, 2256 patients were included. Among them 423 were patients of prostate cancer compared to 1833 were patients of benign prostate hyperplasia (BPH). The pooled sensitivity and specificity of tPSA>4.0 ng/ml, tPSA>10.0 ng/ml and f/tPSA<0.15 as threshold for the diagnosis of prostate cancer were heterogeneity. The areas under SROC (AUC) were 80, 85 and 87%, respectively (P<0.05). The pooled DOR were 8.44(95%CI: 4.45 approximately 16.00), 9.94(95%CI: 4.15 approximately 23.77) and 13.75(95%CI: 6.35 approximately 29.76), respectively (P<0.05). chi(2) test used for testing the heterogeneity. tPSA and f/tPSA made an important performance for diagnosis of prostate cancer in decade among Chinese. The use of f/tPSA<0.15 as threshold maintain a high prognostic accuracy for prostate cancer.