Objective To evaluate the diagnostic value of Em18 by enzyme-linked immunosorbent assay (ELISA) in the patients with alveolaris echinococcosis (AE). Methods We searched MEDLINE, EMBase, PubMed, The Cochrane Library, and other databases to collect the studies which evaluated the diagnostic value of Em18 in the patients with AE. QUADAS items were used to evaluate the quality of the included studies. The heterogeneity of the included studies and meta-analyses was analyzed by using RevMan 4.2.10. The Summary Recevier Operating Characteristic (SROC) curve was performed by meta-disc. Results Eight studies involving 409 patients with AE diagnosed by the gold standard, 1105 patients with other diseases, and 216 healthy people were included. Meta analyses showed that the pooled sensitivity and pooled specificity of purified Em18 in ELISA were 91.5% and 91.7%, and those of recombinant Em18 were 92.2% and 95.7%, respectively. The AUC of SROC of purified Em18 and recombinant Em18 were 0.966 6 and 0.978 9, respectively. Conclusion Purified Em18 and recombinant Em18 have high value in diagnosis of AE by ELISA.