AimThe exosomal programmed death ligand-1(exoPD-L1) has recently become a topic of interest in the field of oncology. But the prognostic role of exoPD-L1 in cancer patients is inconsistent across previous studies. Therefore, a quantitative meta-analysis was performed to evaluate the prognostic and clinicopathological value of exoPD-L1 in cancer patients.Materials and methodsTwenty eligible studies were included in this study. The relationship between baseline level of exoPD-L1 and clinicopathological features, therapeutic response, overall survival (OS) and progression-free survival (PFS) was evaluated.ResultsPooled analysis indicated that high level of exoPD-L1 was significantly associated with higher tumor stage, positive lymph node metastasis, and advanced TNM stage. Elevated exoPD-L1 was associated with short OS [HR = 1.80 (1.27-2.55), p = 0.001]. In the subgroup analysis, high-level exoPD-L1 was consistently associated with poor OS in sample source, detection method, and lymphoma patients. Moreover, elevated exoPD-L1 was predictive of worse PFS [HR = 1.28 (1.13-4.18), p = 0.000]. In addition, a striking difference between cancer patients and healthy donors was observed in the level of exoPD-L1.ConclusionexoPD-L1 is an original and effective liquid biomarker for cancer patients. However, large-scale, prospective investigations are still needed to confirm our findings.