Background: Excision repair cross-complementation group 1 (ERCC1) protein is a member of the nucleotide excision repair (NER) system, which plays an important role in DNA damage repair. Recently, its predictive and prognostic value in nasopharyngeal carcinoma (NPC) has been investigated by several studies. However, their results remain controversial. Objectives: In an attempt to address this issue, we conducted the present comprehensive meta-analysis. Data sources: Studies published until November 2017 were searched. Finally, total 21 literatures involving 22 cohorts and 2921 NPC patients fulfilled the inclusion criteria. Results: The pooled results showed that high/positive expression of ERCC1 predicted poor objective response rate (ORR) [odds ratio (OR) = 2.83; 95% confidence interval (CI) = 2.11-3.80; P<.001], overall survival (OS) [hazard ratio (HR) = 1.77; 95% CI = 1.48-2.12; P<.001], and disease-free survival (DFS) (HR = 1.60; 95% CI = 1.43-1.79; P<.001) in NPC. Low heterogeneity was detected among these studies (ORR: I-2 = 0.0%, P=.776; DFS: I-2 = 38.7%, P=.148; OS: I-2 = 0.0%; P=.530). The results of sensitivity analyses and publication bias verified the reliability of our findings. Conclusions: This study suggested ERCC1 as a potential predictive and prognostic biomarker for the treatment response and survival prognosis of NPC patients.