Chondrosarcoma is the second most common primary bone sarcoma; 18 F-FDG PET and PET/CT are increasingly proposed as tools to evaluate the status of chondrosarcoma but their accuracy remains disputable. The study aims to evaluate the utility of 18 F-FDG PET and PET/CT to differentiate chondrosarcoma from benign cartilaginous lesions and to predict the histopathological grade of chondrosarcoma. Methods A comprehensive search was performed in three electronic databases including Medline/PubMed,

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... Cochrane library and Embase to retrieve diagnostic studies evaluating the role of 18 F-FDG PET or PET/CT for appraising status of chondrosarcoma. The reference lists of related articles were also scrutinized manually. Useful data were extracted to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odd ratio (DOR), the summary receiver operating characteristic curve (sROC) as well as the area under the curve (AUC) of 18 F-FDG PET or PET/CT in diagnosing chondrosarcoma, and pooled weighted mean differences (WMD) of maximum standardized uptake value (SUVmax) between different entities of cartilaginous neoplasms by using Stata 15.0. Results A total of 12 studies provided sufficient data for the quantitative analysis. For the diagnosis of chondrosarcoma, the pooled sensitivity, specificity and DOR of 18 F-FDG PET were 0.84 (95% confidence interval [CI] 0.46 to 0.97), 0.82 (95% CI 0.55 to 0.94) and 24.244 (95% CI 1.985 to 96.148), respectively while those of 18 F-FDG PET/CT were 0.94 (95% CI 0.86 to 0.97), 0.89 (95% CI 0.82 to 0.93) and 112.999 (95% CI 41.341 to 308.866), respectively. The pooled WMD of SUVmax were -0.89 (95% CI -1.67 to -0.10) between benign cartilaginous lesions and grade 1 (G1) chondrosarcoma, -1.94 (95% CI -2.76 to -1.12) between G1 and grade 2 (G2) chondrosarcoma, and -2.37 (95% CI -5.79 to 1.05) between G2 and grade 3 (G3) chondrosarcoma.