ObjectiveTo systematically review the accuracy of the mini-mental state examination scale (MMSE) in the screening of poststroke cognitive impairment (PSCI), and the diagnostic value of different cut-off values of the scale, so as to provide references for the selection of the threshold of the MMSE scale. MethodsDatabases including PubMed, EMbase, Cochrane Library, Web of Science, CINAHL, CBM, VIP, CNKI, and WanFang data were searched for diagnostic tests about MMSE for PSCI from inception to November 2022. Two researchers independently screened the literatures, extracted data and assessed the risk of bias of the included studies. Then, meta-analysis was performed by Stata 16.0 software. ResultsA total of 23 studies involving 1 525 patients were included. The results of meta-analysis showed that after the analysis of bivariate mixed effect model, the optimal cutoff value of MMSE scale was 23/24 (the pooled sensitivity=0.75, 95%CI 0.52 to 0.89; the pooled Specificity=0.90, 95%CI 0.81 to 0.95; DOR=28, 95%CI 12 to 65; AUC=0.92, 95%CI 0.89 to 0.94). The results of hierarchical summary receiver-operating characteristic (HSROC) curve model showed that the pooled sensitivity=0.77, 95%CI 0.70 to 0.83; the pooled specificity=0.76, 95%CI 0.69 to 0.83, Beta=0.1, 95%CI −0.13 to 0.33, Z=0.82, P=0.41, Lambda=2.38, 95%CI 2.12 to 2.64, and the area under the SROC curve was 0.84. Fagan pre-test probability was 38%, positive likelihood ratio was 3.3, positive post-test probability was 67%, negative likelihood ratio was 0.3,negative post-test probability was 16%. ConclusionThe current evidence shows that MMSE has a certain diagnostic value as a screening tool for PSCI, the overall diagnostic efficacy is moderate, and the diagnostic value is highest when the cut-off value is 23/24. Due to the limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.