The incidence and mortality of sepsis are high, and common biomarkers are not perfect. To identify a biomarker with high specificity and sensitivity for sepsis, we evaluated the current literature on the performance of mid-regional pro-adrenomedullin (MR-proADM) in the diagnosis of sepsis.According to appropriate eligibility and exclusion criteria, PubMed, EMBASE, Cochrane Library, China Journal full-text Database, Wanfang Database and Chinese Journal Full Text Database were searched for "Mid-regional proadrenomedullin", "MR-proADM", "Sepsis", "Pyemia", "Pyohemia", "Septicemia" and "Blood poisoning". The publication dates considered for the search were from inception until August 31, 2020. The risk of bias was assessed according to QUADAS-2 criteria.Eleven studies involving 2038 cases were included. MR-proADM had high sensitivity and specificity in the diagnosis of sepsis, with values of 0.83 [95% CI: (0.79-0.87)] and 0.90 [95% CI: (0.83-0.94)], respectively. The odds ratio of a combined diagnosis was 41.35, and the area under the curve (AUC) was 0.91. The best cut-off value for MR-proADM diagnosis of sepsis is 1-1.5 nmol/L. MRproADM may also have value in distinguishing pathogens and identifying sepsis severity and organ failure.MR-proADM is an excellent biomarker for the diagnosis of sepsis with high sensitivity and specificity. The best cut-off value for MR-proADM diagnosis of sepsis is 1-1.5 nmol/L.