BACKGROUND Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer-related death in the world and its poor prognosis is a major concern. Periostin was found to be associated with the prognosis of NSCLC. However, the research results were inconsistent. This meta-analysis evaluated the correlation between periostin expression and the prognosis of NSCLC. MATERIAL AND METHODS A meta-analysis was performed on data acquired from PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Database from inception to 18 June 2022. Published and unpublished studies investigating the correlation between periostin expression and the prognosis of NSCLC were included in this meta-analysis. Eligible studies reported at least 1 of the following clinical outcome measures: overall survival, progression-free survival, cancer-specific survival, relapse-free survival, disease-free survival, or other clinical parameters of prognosis. Pooled hazard ratios (HR) with 95% confidence interval (CI) were calculated using the random-effects model. Sensitivity and subgroup analyses and assessment of publication bias were also conducted. RESULTS This meta-analysis enrolled 2504 NSCLC cases from 12 eligible studies. The hazard ratio for the overall survival was 1.761 (95% CI: 1.022-3.033, P=0.041). Heterogeneity was significant among the studies, but publication bias was lacking. Subgroup analyses were performed based on different issues, such as districts, antibodies and methods for periostin detection. CONCLUSIONS Overexpression of periostin is a negative prognostic factor and is associated with worse overall survival (OS) in NSCLC patients. Periostin may serve as a prognostic biomarker for NSCLC patients.