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Background: There have been several meta-analyses evaluating the effect of n-3 polyunsaturated fatty acids (PUFAs) in critically ill patients, but of these, none focused on patients with systemic inflammatory response syndrome (SIRS). The objective of this meta-analysis was to evaluate the effect of omega-3 fatty acids (n-3 FAs) on this narrow subset. Methods: All relevant articles were searched on MEDLINE, EMBASE, SpringerLink, and the Cochrane Database of Systematic Reviews from 1990 to 2014. Meta-analyses were used to evaluate risk ratios and mean differences with 95% confidence intervals between the n-3 PUFA group and the control group. Subgroup analyses were conducted in terms of the route of fish oil. Results: Nine randomized controlled trials (RCTs) with 783 adult patients were included in this study. Compared with control groups, n-3 FA provision can significantly reduce the incidence of mortality (RR: 0.77 [0.60, 0.97]; P = 0.03; I² = 0%). Secondary outcomes showed no significant differences between groups except for shorter length of hospital stay (weighted mean difference: -10.56 [-19.76, -1.36], p < 0.00001, I² = 99%). Conclusions: Overall, this meta-analysis from RCTs indicates that provision of n-3 PUFAs has a therapeutic effect on survival rate in patients with SIRS. [ABSTRACT FROM AUTHOR]