Background and Aim: Apolipoprotein E refers to a polymorphic protein involved in lipoprotein transport and metabolism. However, the relationship between Apo E gene polymorphism and serum CRP levels remains unclear. The present meta-analysis aimed to comprehensively assess the relationships between Apo E gene polymorphism and serum CRP levels. Method: Comprehensive search of all relevant documents published in PubMed, EMBASE, Web of science, Cochrane Library before April 2020. Calculate the standard deviation of mean (SMD) and 95% confidence interval (CI) with a random effects model. Compare serum CRP levels between different Apo E genotypes and isoforms. Use funnel plots to assess publication bias of studies involved. Results: On the whole, 9 studies including 173 different Apo E genotypes comparisons were involved in the present meta-analysis. Overall, the serum CRP level of the apo E ε3ε4 and ε4ε4 genotypes exhibit lower CRP levels as compared with ε3ε3 (OR= -0.21, 95% CI: -0.25, -0.16, P<0.00001; OR= -0.32, 95% CI: -0.39, -0.25, P<0.00001); Apo E ε2ε2 and ε2ε4 display higher CRP levels as compared with ε4ε4 (OR= 0.38, 95% CI: 0.16, 0.60, P=0.0006; OR= 0.38, 95% CI: 0.27, 0.49, P<0.00001). Moreover, Apo E E4 isoforms achieve lower CRP levels than E2 and E3 (OR= 0.22, 95% CI: 0.17, 0.26, P<0.00001; OR= 0.22, 95% CI: 0.15, 0.29, P<0.00001). Conclusions: As revealed from the present meta-analysis, serum CRP levels are different between different Apo E gene polymorphism, and Apo E genotypes with a higher risk of atherosclerosis exhibit lower serum CRP levels.