Objective To evaluate the perioperative and long-term outcomes of patients with arterial resection (AR) during pancreatectomy for pancreatic cancer. Methods All retrospective cohort studies comparing pancreatectomy combined with arterial resection (AR) and simple pancreatectomy were searched in PubMed, Embase, The Cochrane Library, CNKI and Wanfang databases. The literatures were screened according to inclusion and exclusion criteria. Quality assessment was conducted according to Newcastle-Ottawa Scale. Meta-analyses were carried out with RevMan 5.2 version software and were performed with a fixed effects model comparing patients with or without AR in pancreatectomy. Results The literature search identified 13 studies including 301 and 2 792 patients who underwent pancreatectomy with and without AR. All studies were retrospective cohort studies. Meta-analyses revealed that AR was associated with a significantly increased risk for perioperative morbidity (OR 1.66, 95%CI 1.25~2.21, P=0.0005), perioperative mortality (OR 2.91, 95%CI 1.43~5.95, P=0.003), blood transfusion during operation (OR 2.91, 95%CI 1.75~4.23, P=0.003); and with lower R0 resection (OR 0.45, 95%CI 0.31~0.65, P<0.0001), lower survival rate at 1 year (OR 0.57, 95%CI 0.39~0.84, P=0.005) and 3 year (OR 0.37, 95%CI 0.21~0.65, P=0.0006). Conclusion AR in patients undergoing pancreatectomy for pancreatic cancer is associated with higher perioperative risk and lower survival rate, which needs to be applied cautiously in targeted patients.