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Objective: The aim of this meta-analysis was to evaluate the diagnosis efficacy of endorectal ultrasonography (ERUS) for rectal carcinoma. Materials and Methods: We searched all the published articles about ERUS in evaluation of rectal carcinoma in the electronic databases. The pooled diagnosis sensitivity, specificity, diagnosis odds ratio, a positive likelihood ratio, negative likelihood ratio, and area under the receiver operating characteristic (ROC) were calculated by MetaDiSc-1.4 software. Results: Fourteen studies with 1583 subjects meeting the inclusion criteria were recruited in this meta-analysis. For tumor invasion evaluated by ERUS, the pooled diagnosis sensitivity, specificity, diagnosis odds ratio, positive likelihood ratio, negative likelihood ratio and area under the ROC were 0.95 (0.92-0.97), 0.80 (0.71-0.86), 62.88 (9.30-425.33), 3.66 (2.48-5.39), 0.07 (0.01-0.40), and 0.86; for lymph node involvement evaluated by EU, the pooled diagnosis sensitivity, specificity, diagnosis odds ratio, positive likelihood ratio, negative likelihood ratio and area under the ROC were 0.58 (0.53-0.63), 0.80 (0.77-0.84), 5.93 (4.07-8.63), 2.85 (2.30-3.52), 0.54 (0.46-0.63) and 0.78. Conclusion: ERUS was a good method for the assessment of invasion of rectal tumors and lymph node involvement [ABSTRACT FROM AUTHOR]