Background: End-stage renal disease (ESRD) is a complex process that may be influenced by many factors, including polymorphismin aldosterone synthase CYP11B2-344T/ C (rs1799998) gene. Previous work suggests an association between the CYP11B2-344T/C gene polymorphism and susceptibility to ESRD, but the results have been inconsistent. Methods: PubMed, Embase, Cochrane, Science Direct, and Web of Science were systematically searched to identify relevant studies. A meta analysis was performed to examine the association between CYP11B2 gene polymorphism and susceptibility to ESRD. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: Five studies involving 1,329 ESRD cases (965 Asians, 104 Caucasians and 260 mixed) and 1,193 healthy controls (898 Asians, 133 Caucasians and 162 mixed) were included. In overall analysis, the CYP11B2-344T/ C gene polymorphism had no association with increased or decreased risk of ESRD. In subgroup analysis, TT genotype was significantly associated with increased risk in Asian population in the recessive comparison (TT vs. TC+CCOR=1.28, 95% CI 1.06-1.54, P=0.01). TC genotype was significantly associated with increased risk in Caucasian population in the Heterozygote comparison (TC vs. CC OR=2.19, 95% CI 1.08-4.44, P=0.03). Conclusions: Our meta analysis indicates that TT genotype of CYP11B2-344T/ C gene polymorphism may be a risk factor of ESRD in Asians. Heterozygote TC genotype may be a risk factor of ESRD in Caucasian population. However, these conclusions should be verified in larger, stratified-designed studies.