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OBJECTIVE: To investigate the association of E-selectin S128R polymorphisms with ischemic stroke.DATA SOURCES: A computer-based online search was conducted in PubMed, Elsevier, Ovid Database, the China National Knowledge Infrastructure, and Wanfang Database between January 1998 and December 2010.STUDY SELECTION: Case-controlled studies addressing the association of the E-selectin polymorphism and ischemic stroke were included in this review.The genotype distribution complied with the Hardy-Weinberg genetic equilibrium.The included reports were evaluated by two authors for strict quality screening.Meta-analysis software, REVMAN 5.1, was used to investigate heterogeneity, pooled odds ratio (OR) and 95% confidence interval (CI) in individual studies.MAIN OUTCOME MEASURES: Genotype and allele distributions at the E-selectin S128R site.RESULTS: Six case-controlled studies were included after screening and application of inclusion and exclusion criteria.There was no heterogeneity in the genotype and allele frequencies, and no publication bias was found.Meta-analysis of the pooled data showed that the OR value of the (AC+CC)/AA genotype was 1.93 (95% CI: 1.55-2.41, Z = 5.80, P < 0.000 01), and the OR for the C/A allele was 1.80 (95% CI: 1.47-2.22, Z = 5.59, P < 0.000 01) in the ischemic stroke group, compared with control group.Results of pooled data in Chinese subjects showed that the OR value of (AC+CC)/AA was 2.36 (95% CI: 1.68-3.31, Z = 4.99, P < 0.000 01), and the OR value of the C/A allele was 2.25 (95% CI: 1.63-3.12, Z = 4.89, P < 0.000 01).CONCLUSION: Polymorphism of E-selectin S128R was significantly associated with susceptibility to ischemic stroke; the AC and CC genotypes as well as the C allele may be factors associated with susceptibility to ischemic stroke.