Background <p>The role of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) parameters to predict prognosis for patients with soft tissue sarcoma (STS) remains controversial.</p> Objectives <p>This meta-analysis aimed to systematically evaluate the prognostic significance of ¹⁸F-FDG PET/CT parameters in STS.</p> Design <p>This study is a systematic review and meta-analysis.</p> Data sources and methods <p>A literature search was conducted in PubMed, Embase, and the Cochrane Library for relevant studies up to January 1st, 2024. Studies exploring the association of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) with overall survival (OS) and progression-free survival (PFS) in STS were included. Pooled hazard ratio (HR) with 95% confidence interval (CI) was calculated using random-effects models.</p> Results <p>Nineteen studies with 962 patients were included in our meta-analysis. Among these, 16 studies evaluated the correlation between the SUVmax and OS, 10 studies assessed the relationship between MTV and OS, 9 studies examined the association of TLG with OS, and 8 studies investigated the prognostic value of SUVmax in relation to PFS. The pooled HRs of SUVmax, MTV, and TLG for OS were 1.17 (95% CI: 1.07–1.27),1.87 (95% CI: 1.16–3.03), and 2.00 (95% CI: 0.99–4.01), respectively. For PFS, the pooled HR of SUVmax was1.62 (95% CI: 1.14–2.31).</p> Conclusion <p>This meta-analysis indicates that the metabolic parameter SUVmax derived from ¹⁸F-FDG PET/CT is significantly associated with poor prognosis in STS, for both OS and PFS. Additionally, MTV was significantly correlated with poor OS, whereas TLG did not show a significant relationship with prognosis in patients with STS.</p>