The aim of this study is to perform a systematic review and meta-analysis of the diagnostic value of 320-slice coronary computed tomography (CT) angiography in the diagnosis of coronary artery disease when compared to invasive coronary angiography. A search of different databases was conducted to identify studies investigating the diagnostic value of 320-slice coronary CT angiography. Sensitivity, specificity, positive and negative predictive value estimates pooled across studies were tested using a fixed effects model and analysed at patient-, vessel-and segmentbased assessment. Twelve studies comprising 1592 patients (median, 63 patients, range, 37-240 patients) with a total of 2974 vessels and 21623 segments met selection criteria for inclusion in the analysis. Patients with a high prevalence of coronary artery disease were included in more than 70% of these studies. The mean values and 95% confidence interval (CI) of sensitivity, specificity, positive predictive value and negative predictive value of 320-slice coronary CT angiography were 96.