Objective To systematically evaluate AFP as the diagnostic standard for Chinese primary liver cancer (PLC). Methods A comprehensive electronic search and additional manual tracking were performed to retrieve relevant studies on AFP in diagnosis of Chinese PLC. All studies were divided into three groups according to the cutoff value of AFP: 20 or 25 ?g/L, 200 ?g/L, 400 ?g/L (Groups 1, 2, and 3, respectively). The data about the accuracy of the included studies were extracted for further heterogeneity studies; statistical pooling and SROC (summary receiver operating characteristics) were analyzed using MetaDisc 1.4 software. Results Twenty studies which were selected from 1,062 references met the inclusion criteria. Heterogeneity (except for threshold effect) was found within the three groups. A Meta-analysis was performed using the random effect model. Compared with the other two groups, the specificity of Group 3 (AFP 400 ?g/L) was the highest (0.977, 95%CI 0.967 to 0.985) and sensitivity was the lowest (0.422, 95%CI 0.403 to 0.441). The values of LR+ and dOR were lower than those of Group 2 (AFP 200?g/L) (17.691: 19.669; 32.820: 53.599, respectively). Area under curve (AUC) of SROC and Q index of Group 3 were also lower than those of Group 2 (0.6575: 0.832 3; 0.633 8: 0.782 2, respectively). Conclusion Four-hundred ?g/L of AFP as the diagnostic standard for PLC is not good enough, and we suggest that 200 ?g/L may be better than 400 ?g/L for PLC diagnosis.