A number of studies have reported that HOTAIR expression levels were higher in cancerous tissues than in corresponding noncancerous tissues and overexpression of HOTAIR was prone to lymph node metastasis. This meta-analysis collected all relevant articles and explored the association between HOTAIR expression levels with lymph node metastasis. A literature collection was conducted by searching electronic databases PubMed, Cochrane Library, OVID, Web of Science, and CNKI (up to March 22, 2014). The odds ratio (OR) and its corresponding 95 % confidence interval (CI) were calculated to assess the strength of the association by using RevMan5.2 software. A total of 748 patients from 8 studies were included in this meta-analysis. The results showed there was a significant difference in the incidence of lymph node metastasis between high HOTAIR expression group and low HOTAIR expression group (OR = 2.81, 95 % CI 1.38-5.70, P = 0.004 random-effects model). This meta-analysis demonstrated that the incidence of lymph node metastasis in patients detected with high HOTAIR expression was higher than that in patients with low HOTAIR expression.