Abstract: Objective　To explore the value of urinary interleukin 18 (IL-18) in the early diagnosis of acute kidney injury (AKI) in children. Method　Medline, EMBASE, Cochrane Library, PubMed, Web of Science, Google Scholar, China National Knowledge Infrastructure, VIP and WanFang Database were searched and retrieved. The literature of urinary IL-18 for the diagnosis of AKI in children were obtained from inception to March 2018. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the quality of included literature. Meta-Disc 1.4 and STATA 12.0 software were used to analyze the data. Results　A total of 9 studies were included, including 1214 children. Across all settings, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for urinary IL-18 level to predict AKI were 0.74 (95%CI: 0.69~0.79), 0.66 (95%CI: 0.63~0.69), 2.30 (95%CI: 1.80~2.92), 0.42 (95%CI:0.31~0.56) and 6.50(95%CI: 4.20~10.07), respectively, and the area under the summary receiver operating characteristic curve was 0.779 (S.E.=0.025). Conclusion　Urinary IL-18 is a valuable biomarker for the early prediction of childhood AKI with moderate diagnostic accuracy.