Objectives: Anti-keratin antibody (AKA) is a serum antibody for patients with rheumatoid arthritis (RA), and it has a high specificity. Diagnostic role of AKA in RA was evaluated in this study. Methods: PubMed, EMBASE, and Web of Science were searched to acquire eligible studies. Articles published before 15 March 2018 were considered to be included. Quality Assessment of Diagnostic Accuracy Studies 2 was used to evaluate the risk of bias and application concern of the included articles. Pooled analysis of diagnostic indicators of AKA for RA was conducted by using a random effects model. Subgroup analysis was employed to explore the potential influencing factors. RevMan 5.3, Stata 11.0, and Meta-DiSc 1.4 software were used in this study. Results: A total of 15 studies (2350 positive and 2067 negative participants) were included. The pooled sensitivity was 0.46 (95% CI 0.44–0.48), pooled specificity was 0.94 (95% CI 0.93–0.95), and pooled diagnostic odds ratio was 15.86 (95% CI 9.48–26.52). In addition, the area under the curve was 0.7194. Conclusions: The current evidence indicated that AKA has high diagnostic specificity in RA and may be useful for RA diagnostic application in clinic. [ABSTRACT FROM AUTHOR]