Studies have suggested that extremely low frequency electromagnetic fields (ELF-EMF) may affect physiological functions in animal models. However, epidemiologic studies investigating the association of ELF-EMF with the susceptibility to cancer yield contradictory results. In this comprehensive analysis, we conducted a search for case-control surveys regarding the associations of ELF-EMF and cancer susceptibility in electronic databases. A total of 42 studies involving 13,259 cases and 100,882 controls were retrieved. Overall, increased susceptibility to cancer was identified in the ELF-EMF exposed population (OR = 1.08, 95% CI: 1.01,1.15, P = 0.02). In the stratified analyses, increased risk was found in North America (OR = 1.10; 95% CI: 1.02, 120, P = 0.02), especially the United States (OR = 1.10; 95% CI: 1.01, 1.20, P = 0.03). However, studies from Europe contradict these results. Moreover, a higher risk was found to be statistically significantly associated with the residential exposed population (OR = 1.18; 95% CI: 1.02, 137, P = 0.03). Furthermore, an increased cancer risk was found in interview based surveys (OR = 1.16; 95% CI: 1.00,135, P = 0.04). In device measurement-based studies, a slight increased risk was found only in premenopausal breast cancer (OR = 1.23; 95% Cl: 1.01, 1.49,P = 0.04). Our meta-analysis suggests that ELF-EMFs are associated with cancer risk, mainly in the United States and in residential exposed populations. Methodological challenges might explain the differences among studies. (C) 2015 Elsevier Ltd. All rights reserved.